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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 502700117
Report Date: 07/08/2022
Date Signed: 07/08/2022 02:43:09 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
04/11/2022 and conducted by Evaluator Jason Lund
COMPLAINT CONTROL NUMBER: 27-AS-20220411131346
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:
07/08/2022
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Victor CardonaTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Staff did not administer resident's medications as prescribed

Resident's bathing needs are not being met

Resident's hygiene needs are not being met
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jason Lund arrived at the above facility to deliver findings for a complaint. LPA was met by Administrator Victor Cardona and explained the reason for the visit.

Staff did not administer resident's medications as prescribed- Based on records reviewed and interviews conducted with staff, and witness. Client (C1) went to the Emergency room (ER) on 4/7/2022 and started the medications on 4/8/2022 for ten-day period and seven-day period and was given the medication as prescribed according to facility Medication Administration Record (MAR). The first medication was given four times a day for seven-days and the second medication was given twice a day for ten-days. On The medication was attempted to be pick up by the C1’s conservator pharmacy by Administrator Victor Cardona at C1’s conservator pharmacy but was not able to because he was not authorized to pick up from the pharmacy.
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022
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-20220411131346
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: 07/08/2022
NARRATIVE
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Resident's bathing needs are not being met- Based on records reviewed and interviews conducted with staff, clients and witness. Client (C1) LIC602 dated 5/28/2021 states that C1 has capacity for selfcare, bathing and all personal needs with the guidance of staff. Client (C1) Valley Mountain Regional Center Individual Program Plan (IPP) dated 1/28/2022 states under Personal Care. C1 can bath self but needs prompts and/ or assistance to complete washing hair. C1 will attempt to avoid washing hair.

Resident's hygiene needs are not being met- Based on records reviewed and interviews conducted with staff, and witness. Client (C1) Valley Mountain Regional Center Individual Program Plan (IPP) dated 1/28/2022 states under Personal Care. C1 requires verbal direction, supervision, and assistance to efficiently compete C1’s daily bathing, dressing, and hygiene tasks.

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: Jason Lund
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2