486800936-5-23-2023-21-AS-HDBI-CT8RXA-20230628132424

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 486800936
Report Date: 05/23/2023
Date Signed: 05/23/2023 03:37:05 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/20/2023 and conducted by Evaluator Dominic Tobola

COMPLAINT CONTROL NUMBER: 21-AS-20230320082231

FACILITY NAME:	MC KINLEY CARE HOME #2		FACILITY NUMBER:	486800936
ADMINISTRATOR:	MCKINLEY/EVANS		FACILITY TYPE:	735
ADDRESS:	336 SAWYER STREET		TELEPHONE:	(707) 557-4053
CITY:	VALLEJO	STATE: CA	ZIP CODE:	94589
CAPACITY:	6	CENSUS: 4	DATE:	05/23/2023
		UNANNOUNCED	TIME BEGAN:	02:06 PM
MET WITH:	Barbara McKinley, Licensee		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff left residents unattended
Staff are not properly cleaning resident

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 5/23/2023, Licensing Program Analyst, LPA Tobola arrived unannounced for the purpose of delivering complaint investigation findings to the facility and was greeted by Licensee, Barbara McKinely. LPA toured the facility, interviewed staff, clients and outside parties, reviewed resident records and made observations.

Complaint alleges that staff left residents at the facility unattended. Complainant reported that on 3/17/2023, staff (S1) left clients unattended approximately before 3:30pm. Based on a review of staff timesheets it was found that on 3/17/2023, S1 had time worked from 12:00pm to 4:00pm. In addition, LPA also found that on 3/17/2023, Licensee, Barbara McKinley had worked from 7:00am to 12:00pm and staff (S2) to have worked from 3:40pm to 11:00pm. Due to a lack of corroborating evidence and staff timesheets indicating at least one staff present each shift on 3/17/2023, the allegation is found to be unsubstantiated.

Continued onto LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023

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 2

Control Number 21-AS-20230320082231

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: MC KINLEY CARE HOME #2	FACILITY NUMBER: 486800936
	VISIT DATE: 05/23/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Complaint alleges staff are not properly cleaning resident. Complainant reported client (C1) to have been left in soiled drawers by staff. Based on a review of client records, LPA found that client C1 does not reside in the facility but is located at another facility under the same licensee. Based on interviews with staff (S1) and Licensee, clients are assisted with bathing and found to utilize continence care products. Clients attend day program and are cleaned every morning and night. Upon return they are checked every 2-3 hours for soiled diapers. LPA toured the facility and found clients, client clothing and client bedrooms to be clean and odorless. Staff were also observed directing clients (C2 & C3) to the restroom for toileting with full assistance. LPA observed a sufficient supply of toileting, continence care and hygiene products readily available for resident use. Due to a lack of corroborating evidence the allegation is found to be unsubstantiated.

A finding that the complaint allegations, staff left residents unattended, staff are not properly cleaning resident are unsubstantiated meaning that although the allegations 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 allegations are UNSUBSTANTIATED.

Licensee, Barbara McKinley left during the visit due to emergency. Report was reviewed and signed by Lead Staff, Aliyah Evans.

No deficiencies cited during today's visit. Appeal Rights Given.

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2