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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 547208843
Report Date: 07/03/2024
Date Signed: 07/03/2024 04:38:56 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/22/2024 and conducted by Evaluator Kelly J. McClurg
COMPLAINT CONTROL NUMBER: 24-AS-20240322085619
FACILITY NAME:SOCIAL VOCATIONAL SERVICES, INCFACILITY NUMBER:
547208843
ADMINISTRATOR:REYNOSO, DAWNFACILITY TYPE:
775
ADDRESS:1120 S BEN MADDOX WY STE 100TELEPHONE:
(559) 802-1560
CITY:VISALIASTATE: CAZIP CODE:
93292
CAPACITY:90CENSUS: DATE:
07/03/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Non-Behavioral Program Director (nbPD) Gloria WaldrumTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff aggressively pushed client various times and spoke to client in a derogatory manner
INVESTIGATION FINDINGS:
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A Complaint visit was conducted by Licensing Program Analyst (LPA) K. Mcclurg. LPA met with Non-Behavioral Program Director (nbPD) Gloria Waldrum. LPA stated purpose of visit.

Incident details as occured on 3/21/24 reviewed nbPD, including facility internal investigation. Department findings discussed.

During course of the Department's investigation, it was determined that while the incident did occur, facility Policies & Procedures were appropriately followed. The above allegation has been investigated by the Department & determined to be Substantiated.

Deficiency issued. Deficiency cleared @ time of visit.
Exit interview conducted with nbPD. Report provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Kelly J. McClurg
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
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 3
Control Number 24-AS-20240322085619
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: SOCIAL VOCATIONAL SERVICES, INC
FACILITY NUMBER: 547208843
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/03/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/03/2024
Section Cited
CCR
82072(a)(1)
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82072 Personal Rights:
(a) Each client shall have personal rights which include (1) To be accorded dignity in his/her personal relationships with staff and other persons.
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Policies & Procedures followed including but not limited to: S1 was placed on immediate suspension & re-training planned pending internal investigation. An internal investigation was conducted & findings were determined.
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S1 displayed inappropriate actions & speech directed at C1.
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S1 no longer employed by facility.

DEFICIENCY CLEARED PRIOR TO VISIT.
POC Letter Provided @ time of visit.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Kelly J. McClurg
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 24-AS-20240322085619
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: SOCIAL VOCATIONAL SERVICES, INC
FACILITY NUMBER: 547208843
VISIT DATE: 07/03/2024
NARRATIVE
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Continued from page 1.

Incident details reviewed & discussed.

According to direct witnesses, on 3/21/24 in Library
  • Staff 1 (S1) was sitting next to Client 1 (C1) on couch.
  • C1 was engaging in poking & pushing behaviors towards S1.
  • S1 pushed C1 several times ending with C1 being pushed off of couch.
  • S1 "pulled" C1 back onto couch.
  • After back on couch, S1 made comment to C1 in a derogatory manner as determined through bluntness of statement & tone of voice.
  • Another staff (S2) then intervened to cease any further behaviors between S1 & C1.

Within 1 hour of incident S1 placed on suspension pending internal investigation.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Kelly J. McClurg
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3