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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 502700117
Report Date: 03/30/2023
Date Signed: 03/30/2023 01:45:48 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/12/2022 and conducted by Evaluator Maja Jensen
COMPLAINT CONTROL NUMBER: 27-AS-20220912085352
FACILITY NAME:STEPS HOMEFACILITY NUMBER:
502700117
ADMINISTRATOR:VICTOR MANUEL CARDONAFACILITY TYPE:
735
ADDRESS:560 ASHLAND AVENUETELEPHONE:
(415) 652-6720
CITY:TURLOCKSTATE: CAZIP CODE:
95382
CAPACITY:5CENSUS: DATE:
03/30/2023
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:TIME COMPLETED:
01:50 PM
ALLEGATION(S):
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Staff denied client participation in activities.
INVESTIGATION FINDINGS:
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On 3/30/23 at approximately 1pm, Licensing Program Analysts (LPAs) Maja Jensen and Jennifer Fain arrived at 3000 Geer Rd in Turlock and met with Licensee Victor Cardona for a scheduled visit to deliver findings for this complaint investigation.

During the course of this investigation LPA Jensen interviewed the Licensee, interviewed the conservator for Resident 1 (R1), reviewed a written statement submitted by Staff 1, reviewed video evidence and reviewed R1's Personal and Incidental P & I) fund records . Based on the interviews conducted and records reviewed, it was determined that on 9/2/22 Resident 1 (R1) was asked by staff if he wanted to go out for dinner and he declined. R1 later decided he did want to join the other residents and go out to dinner. The video evidence shows S1 telling R1 he has no money to go out for dinner and therefore cannot join the other residents for this outing. The P & I fund records show that the resident did have sufficient money available to participate in a dinner outing but was denied the opportunity as a result of staff being either unwilling or unable to access the funds at that time. Continued on LIC 9099C...
Continued on LIC 9099
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
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 3
Control Number 27-AS-20220912085352
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: STEPS HOME
FACILITY NUMBER: 502700117
VISIT DATE: 03/30/2023
NARRATIVE
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Continued from LIC 9099...

Deficiencies are being cited from the California Code of Regulations (CCR), Title 22, Division 6. Failure to correct deficiencies may result in the assessment of civil penalties.

An exit interview was conducted and a copy of this report and appeal rights were provided.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20220912085352
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

FACILITY NAME: STEPS HOME
FACILITY NUMBER: 502700117
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/30/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/07/2023
Section Cited
CCR
85709(c)
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Activities
The licensee shall ensure that clients are given the opportunity to attend and participate in community activities...This requirement was not met as evidenced by:
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Licensee agrees to leave a company credit card at facility at all times to prevent this situation from accurring again. Licensee will email an attestation that this regulation has been reviewed, is understood and will be complied with to maja.jensen@dss.ca.gov.
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Based on interviews conducted and records reviewed R1 was not given access to his P&I funds which precluded him from participating in a desired activity. This poses a potential risk to the health, safety and personal rights or 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: Liza King
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3