515000483-12-13-2023-59-AS-LMUZ-CZ7PQB-20240105103052

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 515000483
Report Date: 12/13/2023
Date Signed: 12/13/2023 02:31:52 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH 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
11/01/2023 and conducted by Evaluator Kerry Hiratsuka

COMPLAINT CONTROL NUMBER: 59-AS-20231101151128

FACILITY NAME:	ALMA AMAYA'S FAMILY HOME II		FACILITY NUMBER:	515000483
ADMINISTRATOR:	HOUSTON, MICHAEL		FACILITY TYPE:	735
ADDRESS:	589 BIRD STREET		TELEPHONE:	(530) 671-6816
CITY:	YUBA CITY	STATE: CA	ZIP CODE:	95991
CAPACITY:	6	CENSUS: 5	DATE:	12/13/2023
		UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Alma Amaya		TIME COMPLETED:	02:40 PM

ALLEGATION(S):

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Staff was inappropriately touching and caressing Resident
Staff are asking inappropriate questions about Resident's sex life.

INVESTIGATION FINDINGS:

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LPAs Hiratsuka and Tryon conducted this visit to deliver the results of the allegations above.

Community Care Licensing Division (CCLD) conducted the investigation into the allegations above. CCLD conducted interviews with residents, the resident in question, staff, and witnesses. CCLD also obtained a police report and resident and staff files.

Interview with the now former resident (R1) stated the staff person (S1) in question touched and caressed R1’s knee as well as ask about R1’s sex life. S1 denied it. No witnesses were found to confirm or deny the action for either party involved. Current residents state there are no issues with S1 or any other staff at the facility. Staff stated there is no issue with S1.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kerry Hiratsuka
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023

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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