435202627-12-10-2024-26-AS-KHOS-DC2LRU-20241217075943

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202627
Report Date: 12/10/2024
Date Signed: 12/10/2024 11:22:08 AM

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
11/14/2022 and conducted by Evaluator Komal Charitra

PUBLIC

COMPLAINT CONTROL NUMBER: 26-AS-20221114133731

FACILITY NAME:	LIFE SERVICES ALTERNATIVES INC		FACILITY NUMBER:	435202627
ADMINISTRATOR:	JUSTIN WILLIAMS		FACILITY TYPE:	735
ADDRESS:	1521 RAMITA CT		TELEPHONE:	(408) 727-3411
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95128
CAPACITY:	5	CENSUS: 5	DATE:	12/10/2024
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Administrator, Justin Williams		TIME COMPLETED:	11:35 AM

ALLEGATION(S):

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Facility staff physically and emotionally abused residents

INVESTIGATION FINDINGS:

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On December 10, 2024, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced complaint visit to deliver findings for the above allegation. LPA met with Administrator, Justin Wiliams and explained the purpose of the visit.

Regarding the allegation, facility staff physically and emotionally abused residents, according to the reporting party, Staff 1 (S1) was observed pinching Client 1’s (R1’s) nose and slapping the back of R1’s head. In addition, according to the reporting party, it was alleged that Staff 2 (S2) engaged in emotional abuse with Client 2 (R2) by ridiculing him/her and joking about R2's private parts in front of others. A Co-complainant to this complaint indicated there were two other clients who were also physically abused by S1 and S2.

During the investigation, LPA interviewed administrator, staff and attempted to interview clients, and family members. According to the administrator, he did his own internal investigation and took S1 and S2 off the schedule until investigation was concluded, however based on the investigation, including the SJPD investigation, there were no signs of physical and/or emotional abuse. The administrator indicated that each client has their own physical prompt to help guide themselves to be more independent. In addition, the administrator indicated that these physical prompts are gentle, and it's what works for the clients. (Cont. to 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Cowan April
LICENSING EVALUATOR NAME: Komal Charitra
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024

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-20221114133731

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: LIFE SERVICES ALTERNATIVES INC	FACILITY NUMBER: 435202627
	VISIT DATE: 12/10/2024

NARRATIVE

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LPA was unable to interview clients during this investigation due to clients either being non-verbal or having limited vocabulary. According to family member’s interviewed, they did not observe any signs of abuse at the facility and believe that their loved ones are happy at the facility and the staff care a lot for the clients. In addition, family interviews indicated that clients may need those physical prompts and redirection, however it is not inappropriate or out of bad intent.

Based on staff interviews conducted, S1 and S2 have never been seen touching clients in a rough manner or making fun of the clients. In addition, staff indicated that there is no physical abuse happening at the facility and the staff try their best to give the clients the best support.

Based on interviews conducted and information collected, the department has determined that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Report is reviewed with the administrator and a copy is provided.

SUPERVISORS NAME: Cowan April
LICENSING EVALUATOR NAME: Komal Charitra
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024

LIC9099 (FAS) - (06/04)

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