435201796-1-28-2025-26-AS-ACON-DEFNVA-20250304094737

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435201796
Report Date: 01/28/2025
Date Signed: 01/28/2025 01:46:54 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/02/2023 and conducted by Evaluator Grace Donato

PUBLIC

COMPLAINT CONTROL NUMBER: 26-AS-20231102101815

FACILITY NAME:	NUEVA VISTA		FACILITY NUMBER:	435201796
ADMINISTRATOR:	WEINSTEIN, MICHAEL		FACILITY TYPE:	735
ADDRESS:	18225 HALE AVENUE		TELEPHONE:	(408) 465-8280
CITY:	MORGAN HILL	STATE: CA	ZIP CODE:	95037
CAPACITY:	72	CENSUS: 70	DATE:	01/28/2025
		UNANNOUNCED	TIME BEGAN:	10:04 AM
MET WITH:	Armando Guba		TIME COMPLETED:	01:50 PM

ALLEGATION(S):

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Staff spoke inappropriately to resident
Staff is harassing resident

INVESTIGATION FINDINGS:

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On 1/28/2025 Licensing Program Analyst (LPA) Grace Donato conducted an unannounced complaint investigation visit at the facility. LPA met with Administrator Armando Guba and explained the purpose of the visit.

Regarding the allegation of staff spoke inappropriately and is harassing resident (R1), reporting party (RP) stated that staff are always asking R1 what he/she is looking at on the phone and iPad. R1 feels the staff should not be asking he/she is looking at on the phone, iPad and when R1 is talking to himself/herself about things. R1 feels it's their right to keep these things private. The staff told R1 that if he/she continues to raise their voice at staff, the staff will take away the iPad. R1 does not feel this is right. R1 feels the staff harass him/her and are "singling" R1 out.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Jackie Jin
LICENSING EVALUATOR NAME: Grace Donato
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

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 26-AS-20231102101815

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: NUEVA VISTA	FACILITY NUMBER: 435201796
	VISIT DATE: 01/28/2025

NARRATIVE

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R1 provided additional information during the interview stating that R1 is seeing numbers when he/she is on the phone. Staff are being intrusive, S3 & S5. It started with S5 and said R1 was being disrespectful of being aggravated and has a tone that R1 will get in trouble. R1 doesn't like when they ask what he/she's doing on the phone in front of clients. R1 said its okay if they pull him/her aside. R1 told staff he/she doesn't have to show them anything about family and friends. S3 was asking R1 for pictures.

LPA Dolores interviewed four staff members. S3 mentioned that residents are allowed to use their phone. S3 never questioned R1. They talk all the time. R1 reads his/her kindle a lot and S3 asks what R1 reading. Everyday things. S1 will ask what are R1s interest. R1 usually tells S3 what he/she's reading. When S3 does ask R1 does say it's none of his/her business. S3 just says okay and walk away. For majority of the time, R1 responds well and he/she'll tell her what she's reading and doing. S3 never asked R1 for someone's phone number. S1, S3 & S3 didn’t observe any staff harassing or inappropriately speaking to resident. S4 shared that they prompt the resident because they’re just reminding. S4 mentioned that R1s baseline is having hallucinations and delusions.

Based on records review, R1 has symptoms that include attention-seeking, perseveration on negativity, poor concentration, sleep disturbances, depression, poor impulse control and a history of hallucinations when off medication.

Based on interviews and records review, the department has determined that 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.

Report is reviewed and copy is provided.

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SUPERVISORS NAME: Jackie Jin
LICENSING EVALUATOR NAME: Grace Donato
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

LIC9099 (FAS) - (06/04)

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