502700117-9-14-2022-27-AS-KHOS-CJGHRE-20220921062522

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 502700117
Report Date: 09/01/2022
Date Signed: 09/14/2022 10:29:37 AM

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
06/03/2022 and conducted by Evaluator Jason Lund

COMPLAINT CONTROL NUMBER: 27-AS-20220603175831

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: 5	DATE:	09/01/2022
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Administrator Victor Cardona		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff mocked resident

Staff not providing meals to resident

Staff are not meeting needs of resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jason Lund arrived at the above facility to deliver findings for a complaint investigation. LPA was met by Administrator Victor Cardona and explained the reason for the visit.

Staff mocked resident- Based on interviews with staff, clients and client (C1) mother on 5/16/2022 at approximately 10:00 AM client (C1) came back to the facility from an overnight stay with family. According to interviews C1 was supposed to be back at 11:00 AM. When C1 arrived back to the facility staff and clients were having breakfast and one of the client’s still had breakfast in the microwave waiting for that client. Staff didn’t make C1 breakfast because C1 was not supposed to arrive back to the facility until 11:00 AM. Interviews with Staff stated that they offered to make something else for C1 but C1 wanted the food that was in the microwave for another client. Staff stated that C1 got upset because C1 could not have the food in the microwave. Staff attempted to make something else for C1 to eat, but C1 and mother chose to go outside of the facility to get C1 something to eat for C1.

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

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-20220603175831

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: 09/01/2022

NARRATIVE

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Staff not providing meals to resident- Based on interviews with staff, clients and client (C1) mother on 5/16/2022 at approximately 10:00 AM client (C1) came back to the facility from an overnight stay with family. According to interviews C1 was supposed to be back at 11:00 AM. When C1 arrived back to the facility staff and clients were having breakfast and one of the client’s still had breakfast in the microwave waiting for that client. Staff didn’t make C1 breakfast because C1 was not supposed to arrive back to the facility until 11:00 AM. Interviews with Staff stated that they offered to make something else for C1 but C1 wanted the food that was in the microwave for another client. Staff stated that C1 got upset because C1 could not have the food in the microwave. Staff attempted to make something else for C1 to eat, but C1 and mother chose to go outside of the facility to get C1 something to eat for C1. Mother stated to staff that C1 had breakfast (Pancakes) at C1’s dad house before being dropped off, but C1 still wanted the food in the microwave.

Staff are not meeting needs of resident- 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. C1 can bath self but needs prompts and/ or assistance to complete washing hair. C1 will attempt to avoid washing hair. C1’s mother stated that C1 had mild to serve dandruff. Records indicate that C1 has a history of dandruff and uses Therapeutic shampoo when needed for C1’s dandruff.

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: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

LIC9099 (FAS) - (06/04)

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