<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 471372608
Report Date: 05/16/2024
Date Signed: 05/16/2024 03:45:52 PM

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
03/27/2024 and conducted by Evaluator Sarah Benson
COMPLAINT CONTROL NUMBER: 59-AS-20240327160846
FACILITY NAME:BARKERS RESIDENTIAL CAREFACILITY NUMBER:
471372608
ADMINISTRATOR:CRANE, SANDEEFACILITY TYPE:
735
ADDRESS:200 4TH STREETTELEPHONE:
(530) 905-1409
CITY:MONTAGUESTATE: CAZIP CODE:
96064
CAPACITY:15CENSUS: 11DATE:
05/16/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:David and Erykah Small TIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not provide adequate bed linens for resident.
Resident personal belongings are missing.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 05/16/24 at 3:00 PM Licensing Program Analyst (LPA) Sarah Benson and Licensing Program Manager Lauren Crocker conducted an unannounced visit and met with administrator David and Erykah Small House Manager, Sandee Crane Administrator and Juanita Potts Licensee. The purpose of this visit was to deliver the finding of a complaint investigation.

Staff and Clients were interviewed and a tour of the facilty was conducted. While there was one Client who had reported money missing and another client reported a drivers license missing, there is no evidece that the missing articles were due to failure for the facility staff to safeguard the residents property. Further, during the visit the residents and facilty staff reported that the facility provides clean linens, further discussions around resident behaviors and documentation took place. The preponderance of evedence has not been met so the above allegations are UNSUBSTANTIATED.


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sarah Benson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024
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 1