415601162-12-5-2025-14-AS-BCHN-DQAABT-20260112230516

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 415601162
Report Date: 12/05/2025
Date Signed: 12/05/2025 11:46:05 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/19/2025 and conducted by Evaluator Grace Donato

PUBLIC

COMPLAINT CONTROL NUMBER: 14-AS-20250819104436

FACILITY NAME:	SOCIAL VOCATIONAL SERVICES INC (SSF)		FACILITY NUMBER:	415601162
ADMINISTRATOR:	NAVARRO, CZARINA		FACILITY TYPE:	775
ADDRESS:	192 BEACON STREET		TELEPHONE:	(650) 877-7255
CITY:	SOUTH SAN FRANCISCO	STATE: CA	ZIP CODE:	94080
CAPACITY:	60	CENSUS: 80	DATE:	12/05/2025
		UNANNOUNCED	TIME BEGAN:	08:32 AM
MET WITH:	Ebony Foy		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Facility staff hit clients in care resulting in multiple injuries
Licensee does not ensure facility is adequately staffed to properly supervise clients
Facility staff are not awake when clients require assistances
Facility staff are not properly transporting clients

INVESTIGATION FINDINGS:

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On 12/5/2025, LPA Grace Donato conducted a complaint investigation visit at the facility to deliver findings. LPA met with Program Director Ebony Foy and explained the purpose of the visit.

During the investigation, staff members were interviewed, and records were reviewed.

Regarding the allegation of Facility staff hit clients in care resulting in multiple injuries, a client (R1) sustained injuries and was transported to hospital for stitches. The incident was reported to the department, and it stated that R1 tried to grab another resident’s paper, couldn’t get it and got agitated. R1 tried to hit another staff when asked where R1 is going. R1 lost balance when trying to hit staff with a bag and hit a table. Facility applied first aid and R1 was sent to hospital.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Grace Donato
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025

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 14-AS-20250819104436

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SOCIAL VOCATIONAL SERVICES INC (SSF)	FACILITY NUMBER: 415601162
	VISIT DATE: 12/05/2025

NARRATIVE

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For the allegation of Licensee does not ensure facility is adequately staffed to properly supervise clients, RP stated that clients are frequently left unsupervised for periods of time.

According to staff interviews, there are no issues with staffing in the facility. If anyone calls out or goes on vacation, case managers, program director and even the regional director step in to fill. S3 mentioned that there is a client (R2) who always goes to the back area of the facility. R2 likes playing with water. Staff just redirect R2 and R2 listens.

Regarding the allegation of Facility staff are not awake when clients require assistance, staff are always asleep in rooms at the facility. Based on the interviews, all staff mentioned that they haven’t seen any staff sleeping in the facility. The facility is always busy and there’s always something to do.

Regarding the allegation of Facility staff are not properly transporting clients, RP stated that Staff transport multiple (up to 4-5) clients alone to and from the facility.

According to the Regional Director (RD), drivers are assigned clients to be transported. This is based on clients’ behaviors. Some drivers get a ride-a-long (additional staff) if there is a client on a wheelchair. During the interviews, staff members who drive mentioned that there are no issues with the clients that they transport.

Based on interviews, observations and records review, the department has determined that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Report is reviewed and copy is provided.

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SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Grace Donato
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025

LIC9099 (FAS) - (06/04)

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