405802273-8-4-2023-29-AS-KBUY-CV7LGT-20230830084517

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405802273
Report Date: 08/04/2023
Date Signed: 08/04/2023 10:22:28 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/07/2023 and conducted by Evaluator Mark Jeffries

COMPLAINT CONTROL NUMBER: 29-AS-20230607145156

FACILITY NAME:	STARLING HOME		FACILITY NUMBER:	405802273
ADMINISTRATOR:	DEBORAH STARLING		FACILITY TYPE:	735
ADDRESS:	872 SYCAMORE CANYON RD		TELEPHONE:	(805) 237-7307
CITY:	PASO ROBLES	STATE: CA	ZIP CODE:	93446
CAPACITY:	6	CENSUS: 6	DATE:	08/04/2023
		UNANNOUNCED	TIME BEGAN:	07:50 AM
MET WITH:	Licensee / Deborah Starling,		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Staff spoke to resident in an inappropriate manner.

INVESTIGATION FINDINGS:

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At 7:50am Licensing Program Analyst (LPA) Jeffries arrived unannounced to the facility to deliver final findings to the allegation above to this complaint. LPA met with Licensee Deborah Starling, announced who he was and the reason for the visit. LPA was accompanied by Tri Counties Regional Center (TCRC), Miguel Manga, Quality Assurance Specialist (QA).

As to the allegation of, “Staff spoke to resident in an inappropriate manner.” It was discovered through interviews, and documentation that on 06/05/2023, Staff 4 (S4) reported that they observed and heard S1 use profanity towards Client 1 (C1) while being transported in facility van. Interviews on 06/13/2023, of Clients 1-4, all stated that they did not recall that staff had used profanity recently while being transported in the facility van. Interviews on 06/13/2023 of S3 indicated they have never heard S1 use profanity towards clients. Interviews on 08/01/2023 of S4-S6 indicated that C1 has stated that “staff at facility have yelled at C1” daily. LPA interviewed C1 on 06/13/2023, C1 did not disclose that staff yelled or used profanity towards C1. Both the day program and this facility have submitted incident reports on 06/05/2023 indicating that CONTINUED on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Mark Jeffries
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20230607145156

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: STARLING HOME	FACILITY NUMBER: 405802273
	VISIT DATE: 08/04/2023

NARRATIVE

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there was an issue with C1 while being dropped off in the facility van to the day program with conflicting views of who used profanity and inappropriate communications in each of the two incident reports. In an interview on 08/02/2023, S1 denied any incident on the van on 06/05/2023, stating that clients are addressed on safety issued (wearing seat belts) as needed. At this time, pertaining to the specific allegation on 06/05/2023, there is not enough evidence to support the allegation of, “Staff spoke to resident in an inappropriate manor.” Therefore, this allegation is Unsubstantiated at this time.

However, this is the third documented report to Community Care Licensing Division (CCLD) of staff from this facility speaking inappropriately to clients. All three different independent sources from two different program facilities documenting and reporting to CCLD of facility staff inappropriately speaking to facility clients. Though this investigation pertaining to this complaint’s specific allegation on 06/05/2023 was not substantiated at this time based on the evidence from 06/05/2023 incident reports and interviews conducted. This being the third independent source reporting the same type of allegation (29-AS-20221101162949 and Incident report on 05/05/2023), of staff speaking inappropriately to clients, a technical violation (TV) will be issued based on the third report of the same type of incident, staff speaking inappropriately to clients. A technical violation is issued at this time.

Exit interview, report read, and report provided.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Mark Jeffries
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023

LIC9099 (FAS) - (06/04)

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