079200360-2-14-2023-15-AS-KHOS-CQRLSB-20230410090029

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 079200360
Report Date: 02/14/2023
Date Signed: 02/14/2023 03:48:16 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/10/2023 and conducted by Evaluator Grace Luk

PUBLIC

COMPLAINT CONTROL NUMBER: 15-AS-20230210162148

FACILITY NAME:	TELECARE HOPE HOUSE		FACILITY NUMBER:	079200360
ADMINISTRATOR:	GARCIA, DENISE G		FACILITY TYPE:	772
ADDRESS:	300 ILENE STREET		TELEPHONE:	(925) 313-7980
CITY:	MARTINEZ	STATE: CA	ZIP CODE:	94553
CAPACITY:	16	CENSUS: 8	DATE:	02/14/2023
		UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Ash Ziyar, Clinical Team Lead		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Facility illegally evicted resident.

INVESTIGATION FINDINGS:

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On 2/14/2023 at 1:10PM, Licensing Program Analysts (LPAs) G. Luk and L. Alexander arrived unannounced to conduct complaint investigation and delivered findings in regards to the allegation above. LPAs met with Clinical Team Lead, Ash Ziyar and informed him the reason for visit.

During the course of investigation, LPAs interviewed 4 clients and 2 staff. LPAs also obtained and reviewed discharge summary for 5 clients. Interview with clients indicated they did not witness any clients being evicted from the facility. Interview with staff revealed that the facility is a 14-day program and clients with planned discharges would have a discharge placement.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted. A copy of this report provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Harpreet Humpal	TELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: Grace Luk	TELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

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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