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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486801876
Report Date: 04/04/2024
Date Signed: 05/15/2024 05:27:30 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
02/08/2024 and conducted by Evaluator Jill Nakagawa
COMPLAINT CONTROL NUMBER: 21-AS-20240208084723
FACILITY NAME:A PLACE OF GRACE INC LA CRUZ LANEFACILITY NUMBER:
486801876
ADMINISTRATOR:AMBER PALESIFACILITY TYPE:
735
ADDRESS:851 LA CRUZ LNTELEPHONE:
(707) 447-6393
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY:6CENSUS: 4DATE:
04/04/2024
UNANNOUNCEDTIME BEGAN:
01:58 PM
MET WITH:Bianca Fleming, Interim AdministratorTIME COMPLETED:
03:33 PM
ALLEGATION(S):
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9
Staff do not treat residents in care equally.
Staff do not allow resident to purchase food.
Personal Rights
INVESTIGATION FINDINGS:
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****Amended Report***
Licensing Program Analyst (LPA) Nakagawa arrived unannounced for the purpose of delivering findings on this complaint. LPA met with Administrator Bianca Fleming. Complainant alleges that Staff do not treat residents in care equally. Complainant also alleges that Staff do not allow resident to purchase food.

This Department's investigation has included site visits to facility; review of documents; and statements from staff and witnesses. LPA made the following determinations: clients are cared for according to each client's individual care needs and services, and they all receive special incentives and treatment that is fair and equitable.
(Continued on 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
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 2
Control Number 21-AS-20240208084723
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: A PLACE OF GRACE INC LA CRUZ LANE
FACILITY NUMBER: 486801876
VISIT DATE: 04/04/2024
NARRATIVE
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Continued form 9099....
****AMENDED***

4 Clients were interviewed and 3 of 4 found staff to be fair; the fourth client stated that staff are not fair. Staff stated that they keep each client's goals in mind but are mindful in providing fair treatment to all. Per the investigation, there was no information obtained to support the allegation.

Also, Complainant alleges that Staff do not allow resident to purchase food. Statements from staff indicate that clients are encouraged to make healthy choices but staff never prohibit a resident's purchase. In addition, LPA found that the clients have access to frequent trips to stores and restaurants, and all 4 clients are independent and can use the bus or walk to stores and restaurants in close proximity.

This portion of report has been amended to include the following allegation:

LPA Nakagawa investigated the allegation of personal rights. It is alleged that staff came in to work smelling like weed. LPA interviewed 3 of 4 clients. 2 clients stated they observed the smell of weed on staff on one occasion, but they did not observe them smoking weed. The third client had not made any observations of staff smelling of weed. The fourth client was unavailable for comment. In addition, 2 of 6 staff were interviewed and reported they had not observed any staff “smelling like weed”. Staff (S1) stated they had witnessed a neighbor smoking weed outside, which may have been what the clients smelled, but there had been no instances where they observed other staff or residents smoking marijuana at the facility. Certain smells may be considered uncomfortable or offensive to certain individuals which would be a violation of Personal Rights, however none of the witnesses interviewed expressed that they were not accorded dignity or felt unsafe, or that they were being punished or that the smell was offensive. LPA’s inspections of the facility’s common areas on 12/29/23, 2/13/24, 3/19/24, 4/4/24 have been observed to be clean and odor-free; and staff to be clean and professional. No witnesses expressed any concerns over staff being under the influence of drugs or alcohol. LPA was unable to determine the origin of the smell in the environment therefore the allegation that staff come into work smelling like weed is UNSUBSTANTIATED.

Although the allegations may be true, or valid, based upon observations, statements, and records, there is not a preponderance of evidence to prove the allegations are, or are not, true. Therefore, allegations are UNSUBSTANTIATED.

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2