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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 430701864
Report Date: 05/07/2021
Date Signed: 05/07/2021 02:46:09 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/23/2020 and conducted by Evaluator Christopher Hopkins-Clarke
COMPLAINT CONTROL NUMBER: 26-AS-20200623085925
FACILITY NAME:LYTTON GARDENS COMMUNITY CAREFACILITY NUMBER:
430701864
ADMINISTRATOR:DORIS LEEFACILITY TYPE:
740
ADDRESS:649 UNIVERSITY AVENUETELEPHONE:
(650) 617-7338
CITY:PALO ALTOSTATE: CAZIP CODE:
94301
CAPACITY:55CENSUS: 39DATE:
05/07/2021
UNANNOUNCEDTIME BEGAN:
01:38 PM
MET WITH:Doris LeeTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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-Facility staff is retaliating against the resident for filing a complaint with licensing
-Facility staff are not giving resident's their mail in a timely manner
-Facility staff are tampering with resident's mail
-Facility staff are damaging resident's personal property
INVESTIGATION FINDINGS:
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On 5/7/2021 Licensing Program Analyst (LPA) Chris Hopkins conducted an unannounced complaint investigation regarding the above allegations. LPA met with Administrator Doris Lee via tele-visit due to Covid-19 procedures and explained the purpose of the tele-visit.

Regarding the allegation of Facility staff is retaliating against the resident for filing a complaint with licensing, the Department investigation found the following: LPA Marrufo conducted the initial investigation, and then it was reassigned to LPA Hopkins. LPA Hopkins interviewed staff, and staff stated that they don't know when/if a resident has filed a complaint. Staff also stated that there have never been any incidents of staff retaliating against a resident for filing a complaint.

Report Continued on LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Christopher Hopkins-Clarke
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2021
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 26-AS-20200623085925
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME: LYTTON GARDENS COMMUNITY CARE
FACILITY NUMBER: 430701864
VISIT DATE: 05/07/2021
NARRATIVE
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Regarding the allegation of Facility staff are not giving resident's their mail in a timely manner, the Department investigation found the following: during interviews with staff, staff stated that there is a sign by the mailbox area reminding residents to check their mail daily. If residents receive a package that is too big for their mailbox, it is left on the front desk and staff bring the package to the residents room.

Regarding the allegation of Facility staff are tampering with resident's mail, the Department investigation found the following: during interviews with staff, staff stated that each resident has their own mailbox key. The mailman is the one that puts the mail in the residents mailboxes, there is no way staff could tamper with residents mail.

Regarding the allegation of Facility staff are damaging resident's personal property, the Department investigation found the following: during interviews with staff, staff stated that there has never been an incident of staff damaging residents personal property. One staff stated that if damage to residents personal property were to happen, their protocol would be to immediately notify the resident as well as the manager.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted with Doris Lee. A copy of this report was provided to Doris Lee via email, due to COVID-19 precautionary measures, with a "read receipt" to verify the LIC9099 and 9099-C was received. Doris Lee can print out the report and fax a signed copy to LPA at 650-266-8841 or email to LPA at Christopher.Hopkins-Clarke@dss.ca.gov.
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Christopher Hopkins-Clarke
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2021
LIC9099 (FAS) - (06/04)
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