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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 502700754
Report Date: 05/13/2022
Date Signed: 12/16/2022 10:15:07 AM

Substantiated


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
03/23/2022 and conducted by Evaluator Albert Johnson
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20220323111530

FACILITY NAME:DREAM CAREFACILITY NUMBER:
502700754
ADMINISTRATOR:HAWES, JULIANFACILITY TYPE:
735
ADDRESS:2004 KRUGER DRIVETELEPHONE:
(209) 661-4666
CITY:MODESTOSTATE: CAZIP CODE:
95355
CAPACITY:4CENSUS: 3DATE:
05/13/2022
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:J. HawesTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff spoke inappropriately towards a client while in care
INVESTIGATION FINDINGS:
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This report is being amended as a result of additional information and current documents recieved by the department from the facility on 6/8/2022.

Allegation: Staff made an inappropriate comment towards resident.

Based on interviews conducted the department discovered that staff are allegingly threatening R1 with potentially being homeless, if she continues to contact a former staff, it was also discovered during the investigation that R1 was told by a staff member that if she continues causing problems that she will not get her "Good Girl Money". Former staff and Resident confirmed that the term "Good Girl Money " was used on multiple occasions by staff to redirect R1 when she was not following her programming or intervention plan. During the visit on 5/13/2022, R1 asked the Administrator, "When do I get my Good Girl Money." The Administrator immediately corrected R1 and stated that "we don't use that term here." He then asked her " Who uses that term?" R1 replied, "You" referring to the
Administrator. The Administrator denied using the term and ask R1 "Did you hear that from a former staff?" R1 replied,"Yes". The behavior intervention plan for R1 was not current when this investigation was started. The plan reviewed at the time of the investigation was outdated. The department was able to obtain a current intervention plan dated 5/25/2022. Based on the current intervention plan the facility is to use a token reward system. This system requires points for R1's compliance which can be used to get gift cards, privileges and other identified items. There is no mention of money in the plan.

The citation was given on the amended report dated 6/22/2022 for the allegation listed above therefore the facility will address the plan of correction on the amended report and will not have a 9099D page for the substantiated personal rights finding.
Substantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20220323111530
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: DREAM CARE
FACILITY NUMBER: 502700754
VISIT DATE: 05/13/2022
NARRATIVE
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 The department has re-investigated this complaint and determined it to be SUBSTANTIATED. This was based on new information received by the department form the facility.
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3