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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 502700117
Report Date: 11/07/2024
Date Signed: 11/07/2024 05:03:16 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
07/20/2024 and conducted by Evaluator Renee Campbell
COMPLAINT CONTROL NUMBER: 27-AS-20240720232654
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: 4DATE:
11/07/2024
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Ayala Renica, Direct Support ProviderTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Staff pushed a resident in care.
Staff threatened a resident in care.
Staff are sleeping during shifts.
Staff yells at a resident in care.
Staff locked resident out of facility.
INVESTIGATION FINDINGS:
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On 11/07/2024, Licensing Program Analyst (LPA) Renee Campbell arrived unannounced to the facility to complete a complaint investigation. LPA Campbell met with Ayala Renica, Direct Service Provider and explained the purpose of the visit.

Regarding the allegations above, LPA Campbell interviewed 3 of the 4 residents currently residing at the facility and 4 of the 11 staff currently working at the facility. Neither Resident 1 (R1), R2 or R3 were able to verify the allegations and all three stated they liked living in the facility. Of the 4 staff interviewed, neither Staff 1(S1), S2, S3 or S4 stated the allegations above were true. All staff interviewed reported they had no knowledge of other staff pushing, yelling at or threatening residents. S1, S3 and S4 reported that when all the staff on shift were on an outing with the 3 other residents, one resident could not get in because they returned to the home earlier than they had reported they would to staff.


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
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 27-AS-20240720232654
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: STEPS HOME
FACILITY NUMBER: 502700117
VISIT DATE: 11/07/2024
NARRATIVE
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Due to the above noted information, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, and therefore this allegation is UNSUBSTANTIATED. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 6, no deficiencies cited. Exit interview was held and a copy of report was given to Ayala Renica .
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2