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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 471372608
Report Date: 12/02/2024
Date Signed: 12/02/2024 03:12:19 PM

Substantiated


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
05/08/2024 and conducted by Evaluator Sarah Benson
COMPLAINT CONTROL NUMBER: 59-AS-20240508103355
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:
12/02/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Administrator Erykah Smith and House Managers DavidTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Facility is insolvent.
INVESTIGATION FINDINGS:
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On 12-02-24, Sarah Benson, Licensing Program Analyst (LPA) arrived at the facility unannounced to deliver final findings regarding a complaint that was received on 05-08-24. LPA Benson met with Administrator Erykah Timberlake Small and House Managers David, Administrator, and explained the purpose of the visit.

During the interview process a water company employee, two 2 staff persons and five 5 residents were interviewed. The following documents were received and reviewed: Client and staff list with telephone numbers, employee work schedule, bank statements, bank account number and observation logs.
Based on interviews and evidence obtained during the investigation, the preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22), is being cited on the attached LIC9099D.

Appeal rights were provided. An exit interview was conducted. A copy of the report was provided to House Manager David Small and a copy emailed to administrator.
Continued on LIC9099-D
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sarah Benson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2024
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 4
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
05/08/2024 and conducted by Evaluator Sarah Benson
COMPLAINT CONTROL NUMBER: 59-AS-20240508103355

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:
12/02/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Administrator Erykah Smith and House Managers DavidTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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9
Staff behavior poses as a risk to the clients.
INVESTIGATION FINDINGS:
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It was reported the staff’s behavior may pose a risk to the clients financially.
During the interview process, two 2 staff persons and five 5 residents were interviewed. The following documents were received and reviewed: Client and staff list with telephone numbers and employee work schedule.
All clients have reported that staff have never ask them for money. All clients living at the facility currently are conserved. Clients reported they like living at the facility and are fed well.

Based on the interviews conducted the allegation is UNSUBSTANTIATED. Although the allegation 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 allegation is unsubstantiated.

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

DATE: 12/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 59-AS-20240508103355
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: BARKERS RESIDENTIAL CARE
FACILITY NUMBER: 471372608
VISIT DATE: 12/02/2024
NARRATIVE
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During the investigation process, it was discovered the licensing fees for 2023 have not been paid and late fees have been applied. The licensing fees for 2024 are due 12-2024. Staff reported the taxes at the facility have not been paid for the last couple years.

Most of the people interviewed, indicated that the power was shut off for a day. It was reported by a client the power was off for one day but it was ok because staff gave us flashlights. The staff reported a mix up of the electric payment because the payment was put on the wrong account number. Staff reported the power was only off for a few hours. Staff reported It was reported by the water company the facility has had the water shut off three times in 2024 and eight to ten red tags were given for late fees due to late payment.

Staff reported the electricity was the only utility that has been shut off in 2024. However, It was reported by the water company the facility has had the water shut off three times in 2024 and eight to ten red tags were given with late fees added to late payments. According to staff they are not entirely aware of their financial situation and do not have a sound financial plan.

Based on investigation, observations, interviews which were conducted and recorded and record review(s), the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, (Title 22), is cited on the attached LIC 9099D. Appeal rights were provided and exit interview conducted.

Appeal Rights were explained and provided to the facility representative listed above and an exit interview was conducted. If any of the cited deficiencies are not corrected by the noted due date, civil penalties may be assessed.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sarah Benson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 59-AS-20240508103355
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: BARKERS RESIDENTIAL CARE
FACILITY NUMBER: 471372608
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/02/2025
Section Cited
CCR
80062(a)(1)
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The licensee shall meet the following financial requirements:
(1) Development and maintenance of a financial plan which ensures resources necessary meet operating costs for care and supervision of clients. This requirement is not met as evidenced by:

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The administrator agrees to submit email or fax to the LPA, a statement of how this type of deficiency will be avoided in the future.
Create a ledger of bills going out and income received and email LPA Benson.
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 Based on record review, interviews of staff persons and residents, the licensee did not implement a financial plan that ensures resources necessary to meet operating costs for care and supervision of clients. This poses an immediate health, welfare and safety hazard to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sarah Benson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 4