<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 502700117
Report Date: 09/30/2021
Date Signed: 10/06/2021 01:38:41 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
04/29/2021 and conducted by Evaluator Albert Johnson
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20210429165023
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: 5DATE:
09/30/2021
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:CardonaTIME COMPLETED:
12:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff yells at resident.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Albert Johnson made contact with V. Cardona, Administrator to deliver findings.

Based on records reviewed and interviews conducted with staff and residents it was discovered that on 4/24/2021 R1 was taken to Doctor s Medical Center due to stomach pain and vomiting. Upon arrival, R1 spoke with his nurse and stated that he doesn't like his home, nor his RSP and stated that he doesn't want to go back there. After speaking with R1' s nurse, she stated she had a very emotional conversation with him in which he stated that RSP Victor, is mean to him and yells at him all of the time. R1 stated that he doesn't want to leave the hospital with Victor and doesn't want to return to his home. R1 did not return to the home and is living at another facility.
Continued
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2021
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-20210429165023
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: 09/30/2021
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
R1's has lived at the facility for two years and has identified behaviors of disruptive social behavior, emotional outburst, making false allegations and depression. R1's behavior plan/ service plan addresses these maladaptive behaviors. The facility has documented frequency of behaviors and provided these reports to his planning team.

All parties interviewed by LPA Johnson denied witnessing R1 being yelled at or mistreated by staff.

Valley Mountain Regional Center Liaisons also interviewed residents in care and staff, all interviewed denied witnessing, or being talked to disrespectfully by any staff including Victor Cardona.

The Department (CCLD) has found the allegations. Unsubstantiated.

A finding that the complaint allegation(s) are UNSUBSTANTIATED means that although the allegation(s) may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation(s) occurred.

SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2