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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 515002008
Report Date: 04/22/2020
Date Signed: 07/03/2020 11:50:15 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASETT RD., STE. 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/12/2020 and conducted by Evaluator Emmanuel Ugbah
COMPLAINT CONTROL NUMBER: 25-AS-20200312104221
FACILITY NAME:EMERALD OAKSFACILITY NUMBER:
515002008
ADMINISTRATOR:BAKER, BECKYFACILITY TYPE:
740
ADDRESS:2290 FORREST LANETELEPHONE:
(530) 751-0511
CITY:YUBA CITYSTATE: CAZIP CODE:
95993
CAPACITY:99CENSUS: DATE:
04/22/2020
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:TIME COMPLETED:
12:30 PM
ALLEGATION(S):
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9
Staff do not meet training requirements.
INVESTIGATION FINDINGS:
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13
On 04-22-2020, LPA contacted administrator Becky Baker regardings allegations that facility staff did not meet training requirement. Becky stated that each staff employed by facility is trained before working with residents.

During this conversation, LPA requested and obtained facility policy for staff training, interviewed staff and residents and also obtained staff training records. LPA confirmed that, staff need to complete 20 hour prior to working independantly with resident.

Based on review of documents obtained and interviews conducted, the investigation into the allegation is completed and the allegation is unfounded.
Meaning that the allegation is false and could not have happened, and or is without a reasonable basis.

No deficiencies cited during todays conversation. Exit interview completed and a copy given.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Rayna L BrysonTELEPHONE: (530) 895-5991
LICENSING EVALUATOR NAME: Emmanuel UgbahTELEPHONE: (530) 895-4275
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2020
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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