525002751-5-7-2024-59-AS-LMUZ-D59PBJ-20240514111026

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 525002751
Report Date: 05/07/2024
Date Signed: 05/07/2024 01:36:30 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
05/03/2024 and conducted by Evaluator Rebecca Knight

COMPLAINT CONTROL NUMBER: 59-AS-20240503135955

FACILITY NAME:	D & S CARE HOMES, LLC		FACILITY NUMBER:	525002751
ADMINISTRATOR:	BORTZ JR, DAVID L.		FACILITY TYPE:	735
ADDRESS:	760 MELTON COURT		TELEPHONE:	(530) 864-2341
CITY:	RED BLUFF	STATE: CA	ZIP CODE:	96080
CAPACITY:	4	CENSUS: 4	DATE:	05/07/2024
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Eric Martinez - care staff		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not prevent resident from harassing other residents - UNSUBSTANTIATED

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

05/07/2024 10:00 AM Licensing Program Analyst (LPA) Rebecca Knight, made an unannounced visit to the facility and met with Eric Martinez - care staff. Licensee David Bortz was provided the investigation results by telephone and gave auhtorization for Eric Martinez - care staff to sign the report. The purpose of this visit was to deliver the results of a complaint investigation.

During the course of the investigation LPA interviewed the licensee, two staff and two clients.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024

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 59-AS-20240503135955

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: D & S CARE HOMES, LLC	FACILITY NUMBER: 525002751
	VISIT DATE: 05/07/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Staff did not prevent resident from harassing other residents – UNSUBSTANTIATED

It was reported that Client 2 (C2) is harassing Client 1 (C1) and other clients who live in the home with disruptive and vocal behaviors. Staff are aware of C2’s behaviors towards other clients and do not know what to do with C2.

Staff interviews revealed that other clients who live in the home try to not mingle with C2 because of C2’s outbursts and don’t feel comfortable around C2 sometimes. When C2 has these behaviors staff talk to C2 and tell them that they need to respect their roommates. If C2’s behavior becomes really bad staff will ask the other clients if they want to move so they don’t feel uncomfortable in their home.

Client interviews revealed that C2 is mean to other clients who live in the home and the other clients will go to their rooms when C2 starts behaving in this manner.

It was determined that staff have been working with C2 to remind them to respect their roommates and when C2 chooses not to do this the other clients in the home are given the choice to go in their rooms. The facility has submitted upwards of 35 incident reports since January 2024 related to the disruptive behavior that C2 exhibits in the home. The complainant explicitly stated that the home provides excellent care. This allegation is unsubstantiated.

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

An exit interview was conducted. A copy of the report was provided to Licensee David Bortz.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 2