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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455002618
Report Date: 07/08/2024
Date Signed: 07/08/2024 11:17:17 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/11/2024 and conducted by Evaluator Ivan Avila
COMPLAINT CONTROL NUMBER: 59-AS-20240311084905
FACILITY NAME:DE MOLL HOMEFACILITY NUMBER:
455002618
ADMINISTRATOR:VICTORINE, CHAYLENEFACILITY TYPE:
735
ADDRESS:1213 DE MOLL DRIVETELEPHONE:
(530) 410-9627
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY:4CENSUS: 3DATE:
07/08/2024
UNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Iliana CortezTIME COMPLETED:
11:35 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not treat resident with respect
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 07/08/2024 Licensing Program Analyst (LPA) Ivan Avila conducted an unannounced complaint investigation visit regarding the above allegation directed by the Department. LPA met with Iliana Cortez and explained the purpose of the visit.

During the investigation process, interviews and a records review were initiated.
LPA investigated the allegation, “Staff does not treat resident with respect.” Based on interviews conducted and observation, staff appeared to be attentive to resident’s needs and treating residents with dignity and respect. A resident stated that facility staff is treating all residents with respect and dignity and did not express any concerns. Staff interviews stated they have never had any issues with residents being threatened or mistreated in any way. In addition, no staff has ever heard another staff treating residents without dignity and respect.
Although the allegation 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 allegations are UNSUBSTANTIATED.
An exit interview was conducted a copy of the report and appeal rights were provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Ivan Avila
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2024
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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