435201796-3-13-2025-26-AS-KHOS-DFYMB5-20250422092722

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435201796
Report Date: 03/13/2025
Date Signed: 03/13/2025 12:12:08 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
03/05/2025 and conducted by Evaluator Christine Kabariti

COMPLAINT CONTROL NUMBER: 26-AS-20250305103058

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:	DATE:	03/13/2025
		UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Mark Castillo		TIME COMPLETED:	12:20 PM

ALLEGATION(S):

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Staff spoke inappropriately about resident in care
Staff did not prevent residents from inappropriately touching resident in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christine Kabariti arrived unannounced to open the initial complaint investigation. LPA met with Administrator, Mark Castillo.

On 03/05/2025, the Department recieved the complaint. On 03/13/2025, the initial complaint investigation was conducted. The following documents were obtained to inlcude the resident roster, staff schedule, resident (R1)'s physician's report, appraisal/needs and services plan, and face sheet.

It was alleged that staff spoke inappropriately about resident (R1) during groups by calling a resident an inappropriate name. Page 1 of 3.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Jackie Jin
LICENSING EVALUATOR NAME: Christine Kabariti
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025

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

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 26-AS-20250305103058

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: 03/13/2025

NARRATIVE

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On 03/13/2025, resident (R1) was interviewed. Based on interview, R1 stated that one morning during morning announcements staff (S1) had called R1 an inappropriate name. R1 stated to have heard S1 call R1 the inappropriate name to other clients. R1 reported the incident to 2 other staff members.

Based on interview with the 2 staff members, it was stated that after groups staff (S2) observed R1 talking to him/herself in the hallway and observed R1 was visibly upset. S2 pulled R1 aside, where R1 stated that S1 called him/her an inappropriate name. S2 asked who was around during the time who may have heard the incident, however, R1 stated to feel that other people would not speak up for him/her. S2 interviewed other residents who denied observing staff speak to R1 inappropriately. S3 stated that upon talking to S1, S1 denied speaking to and about R1 inappropriately.

Staff (S1) was interviewed. Based on interview, S1 denied speaking inappropriately about R1. S1 states that during the morning group there were about 30 residents participating. S1 states that he/she observed that R1 was talking to him/herself, however, was too busy to pay attention to what R1 was saying. S1 stated that after the group, S1 was pulled aside and was accused of speaking inappropriately to and about R1, which S1 denied. S1 states that he/she does not think he/she even talked to R1 that morning, and if so, it would've been a simple "hi" and nothing further.

3 residents were interviewed. Based on interview, 3 out of 3 residents attends groups and denied a staff member calling a resident an inappropriate name.

It was alleged that the staff did not prevent 4 other residents from inappropriately touching another resident (R1) in care.

On 03/15/2025, R1 was interviewed. R1 named instances wherein 4 resident's inappropriately touched him/her in various body parts. Each incident was when R1 was in line for snacks, meals or medication. Page 2 of 3.

SUPERVISORS NAME: Jackie Jin
LICENSING EVALUATOR NAME: Christine Kabariti
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 26-AS-20250305103058

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: 03/13/2025

NARRATIVE

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4 staff members were interviewed. Based on staff interview, 4 out of 4 staff denied observing a resident inappropriately touch R1. Based on staff interview, it was stated that R1 has history of making accusations towards staff and residents. It was stated that R1 may feel bothered when someone is too close to him/her.

3 residents were interviewed. Based on interview, 3 out of 3 residents denied observing a resident inappropriately touch another resident in care.

Based on record review, R1 has history of having thought of staff or peers talking about him/her and will respond by voicing that he/she is being mistreated. It's stated that R1 experiences auditory and visual hallucinations. The facility has an objective/plan to help meet R1's needs.

The Department has investigated the above allegations. Based on interview, record review and observation the above allegations are unsubstantiated, meaning, although the allegation may have happened and/or is valid there is not a preponderance of evidence to prove the alleged violations did or did not occur.

No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Administrator, Mark Castillo and a copy of the report was provided.

Page 3 of 3.

SUPERVISORS NAME: Jackie Jin
LICENSING EVALUATOR NAME: Christine Kabariti
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2025

LIC9099 (FAS) - (06/04)

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