502700117-6-23-2023-27-AS-KHOS-CT9KUY-20230629081331

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 502700117
Report Date: 06/23/2023
Date Signed: 06/23/2023 03:42:31 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, 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
09/19/2022 and conducted by Evaluator Maja Jensen

COMPLAINT CONTROL NUMBER: 27-AS-20220919185104

FACILITY NAME:	STEPS HOME		FACILITY NUMBER:	502700117
ADMINISTRATOR:	VICTOR MANUEL CARDONA		FACILITY TYPE:	735
ADDRESS:	560 ASHLAND AVENUE		TELEPHONE:	(415) 652-6720
CITY:	TURLOCK	STATE: CA	ZIP CODE:	95382
CAPACITY:	5	CENSUS: 4	DATE:	06/23/2023
		UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Victor Cardona		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

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Staff hit resident
Facility did not notify resident's responsible party of a change in resident's condition
Staff refused to talk to clients conservator
Staff took clients P&I to buy meals

INVESTIGATION FINDINGS:

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On 6/23/23 at approximately 10:45am Licensing Program Analyst Maja Jensen arrived at facility unannounced to continue a complaint investigation in to the above listed allegation. LPA Jensen met with Victor Cardona and explained the purpose of today's visit.

The investigation was completed during the course of this visit and findings were delivered as follows:

Staff hit resident
During the course of this investigation interviews were conducted with 5 staff members, 2 clients and the alleged victim and alleged victim's responsible party. Records were also reviewed including the full facility file, Regional Center documents, a police report, school records and incident reports. All staff and clients interviewed deny having any knowledge of or having witnessed any physical abuse by staff towards clients. The alleged victim denies getting hit by staff.
Continued on LIC 9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 27-AS-20220919185104

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: 06/23/2023

NARRATIVE

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Continued from LIC 9099...

The records reviewed including the Individual Support Plan (ISP) and Behavior Intervention Plan (BIP), Individual Program Plan (IPP), document a history of the client engaging in self injurious behavior and false allegations. There is no evidence of staff hitting the resident contained in the Turlock Police Depart report. Based on the interviews conducted and the records reviewed the allegation of Staff hit resident is UNSUBSTANTIATED.

Facility did not notify resident's responsible party of a change in resident's condition
During the course of this investigation interviews were conducted with staff and records were reviewed including but not limited to the ISP, IPP, BIP, Medication Administration Records, Physician orders, weight records, staff charting notes, incident reports and email correspondence between staff and the Administrator. There appears to have been a change in medication on or around August 5 where there was an increase in anticonvulsant class of medication. There was no evidence found to suggest there was an associated change in condition. The records indicate that Resident 1 (R1) has attention seeking behaviors. 3 Staff members interviewed stated that R1's behaviors would change specifically in the presence of or when talking to their conservator. The records reviewed support an increase in maladaptive behavior around the responsible party. Based on records reviewed and interviews conducted the allegation of facility did not notify resident's responsible party of a change in resident's condition is UNSUBSTANTIATED.

Staff refused to talk to clients conservator
During the course of this investigation interviews were conducted with 5 staff members and 1 responsible party. An email communication exchange was also reviewed. The Administrator advised during the course of an interview that shortly prior to the date this complaint was reported he asked a responsible party to use email for all non-essential communication and to call for urgent matters. He states he sought to have communication in writing as safeguard against himself and his staff. 2 additional staff members interviewed advised that there had been false allegations made and that it had become problematic. LPA Jensen reviewed an email from the responsible party to the Administrator and notes the response time was 39 minutes. None of the staff interviewed stated that they were aware of any refusal of staff to communicate with a responsible party or conservator. Based on the records reviewed and the interviews conducted this allegation is UNSUBSTANTIATED.
Continued....

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2023

LIC9099 (FAS) - (06/04)

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Control Number 27-AS-20220919185104

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: 06/23/2023

NARRATIVE

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Staff took clients Personal & Incidental (P&I) funds to buy meals
LPA Jensen conducted interviews with 5 staff members and 3 clients. The staff members all deny ever using P&I funds for "extra" meals. All clients interviewed state they have the ability to choose what they want to eat and how the P&I funds are spent. During an interview with the Administrator, Victor Cardona, he advised there was an occasion when the clients went on an outing for Sandwiches. R1 wanted to purchase 2 sandwiches and was able to do so. The responsible party for R1 did not feel it was appropriate for R1 to buy 2 sandwiches because he cannot eat 2 sandwiches at 1 sitting. One resident interviewed stated that not only do they have full choice of what food they buy but they also choose what food will be bought for the groceries within the home. Based on the interviews conducted and a lack of contradictory evidence the allegation of
Staff took clients Personal & Incidental (P&I) funds to buy meals is UNSUBSTANTIATED.

A finding of unsubstantiated means that although the allegation may have happened, the preponderance of evidence does not prove it.

No deficiencies are being cited as a result of this investigation.

An exit interview was conducted and a copy of this report, appeal rights, and the LIC 811 was given to Victor Cardona.

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2023

LIC9099 (FAS) - (06/04)

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