275200693-8-5-2022-26-CR-HWOG-CHUSYZ-20220901141820

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 275200693
Report Date: 07/29/2022
Date Signed: 08/05/2022 03:13:38 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, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/28/2022 and conducted by Evaluator Paul Simien

PUBLIC

COMPLAINT CONTROL NUMBER: 26-CR-20220128142320

FACILITY NAME:	PEACOCK ACRES GROUP HOMES INC.		FACILITY NUMBER:	275200693
ADMINISTRATOR:	ERNEST HOWARD		FACILITY TYPE:	733
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	6	CENSUS: 3	DATE:	07/29/2022
		UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Clarissa Joseph, Residential Manager (RM) and Steisha Monderoy, Strategic Project Director (SPD		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Facility does not have sufficient staff

Facility does not provide a safe environment for youths in care

A youth was involved in an altercation with another youth while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Paul Simien made an unannounced visit to the above listed facility main office to inform them of the findings for the above listed allegations. LPA met with Clarissa Joseph, Residential Manager (RM) and Steisha Monderoy, Strategic Project Director (SPD) at 12:40 PM on 7/29/22.

During the investigation, LPA Simien conducted confidential interviews. They were conducted on 2/26/22, 3/3/22, and 7/7/22.

LPA Simien reviewed and obtained copies of client files, needs and service plans, treatment plan, safety plan for clients, a copy of the staff schedule from 1/1/22-1/31/22, current phone list, graveyard time punch log (staff check in every 30 minutes) from 1/1/22-1/31/22, sleep chart documents for the weeks of 1/1/22 through 1/31/22 for clients, daily mental health progress notes for clients from 1/1/22-1/31/22 and house notes from 1/1/22-1/31/2022, police report numbers and name of responding officers, incident reports for clients for December 2021 and January 2022.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Helga Wong
LICENSING EVALUATOR NAME: Paul Simien
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022

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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Control Number 26-CR-20220128142320

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: PEACOCK ACRES GROUP HOMES INC.	FACILITY NUMBER: 275200693
	VISIT DATE: 07/29/2022

NARRATIVE

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On 1/27/22, the County received a 14-day notice for a client residing at Peacock Acres. A County representative (CR) claimed they were told the reasoning for this is because Peacock Acres did not have enough staff to safely provide supervision for the client. CR said that the facility mentioned an altercation the youth in question had to show this. This led to the allegations that Peacock Acres does not have sufficient staff, does not provide a safe environment, and a youth was involved in an altercation with another youth while in care. RCR felt that the 14-day notice was unjustified because they felt the client in question was making progress and that they should not be given a 14-day notice because of lack of staffing.

On 3/3/22 when LPA Simien asked Peacock Acres about the client’s issues and why a 14-day notice was issued. Peacock Acres explained, since placement, the client has struggled with several behavioral challenges that the program is unable to effectively address. These challenges have continued to impede Client’s ability to make progress towards his treatment goals and have continued to pose a risk to safety of staff and other residents of the program. Included in these challenges are ongoing property destruction, continuing to store and smoke marijuana in the home, verbal threats to kill and/or harm both staff and other residents, theft of Peacock Acres and other resident’s property with intention to sell, and, inciting and provoking another resident to become physically assaultive, punching another resident several times, and ongoing harassment of another resident (refusing to let that resident use the kitchen or exit his room), purposely destroying other resident's property and stalking other residents around the home while posturing and yelling threats and homophobic/transphobic slurs, throwing items at other residents resulting in property damage. The client has been unresponsive to lower level interventions instead requiring police intervention, has been unable to commit to maintaining the ongoing safety of the home and other residents, and voiced his ongoing intention to try to harm other residents. His behaviors have resulted in marked increases in the mental health symptoms of other residents, required Peacock Acres to temporarily place residents in another lower level home to ensure their safety, and have prevented clinical staff from implementing therapeutic components of the program (ex: providing group therapy) due to the need for increased staff ratios to help stabilize the client and maintain safety in the home.

When LPA Simien mentioned to Peacock Acres the allegation of not having sufficient staff and that CR claimed that they said they didn’t have enough staff, they said that they are maintaining proper staff-to-client ratios based on ILS V.4 standards. They also mentioned that the client in question is much larger than the average client and that it would take more than one staff member to subdue and redirect the client in question.

SUPERVISORS NAME: Helga Wong
LICENSING EVALUATOR NAME: Paul Simien
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022

LIC9099 (FAS) - (06/04)

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Control Number 26-CR-20220128142320

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: PEACOCK ACRES GROUP HOMES INC.	FACILITY NUMBER: 275200693
	VISIT DATE: 07/29/2022

NARRATIVE

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They said they could not risk the whole program for one client. At the time of LPA Simien’s inspection of Peacock Acres on 2/16/22 they had the proper client-to staff ratio. Based on the review of staff schedules from 1/1/22-1/31/22 it showed that Peacock Acres did have the proper client-to-staff ratio, although there is no way LPA Simien can confirm staff worked those shifts.

CR said that because Peacock Acres does not have enough staff and the altercations the client in question is having, Peacock Acres does not provide a safe environment. When LPA Simien brought up the allegation that the facility does not provide a safe environment, staff responded by saying they felt they provide a safe environment for clients. They mentioned that some of the clients (including the client in question) behaviors and actions create an unsafe environment. Based on confidential interviews LPA conducted with clients on 2/26/22 clients felt that Peacock acres provided a safe environment and only other clients make them feel unsafe. The clients LPA Simien interviewed mentioned the client in question as creating an unsafe environment. LPA Simien asked clients “Has there been any time you have felt or observed yourself, staff, or other kids being in danger at Peacock?”. They responded, only when the client in question gets upset, this individual tends to physically attack people. They also mentioned that the client in question bullies and attacks them and because of this they do not like the client in question.

When LPA Simien brought up the allegation that a youth was involved in an altercation with another youth while in care, staff responded that although altercations happen between clients, they respond to them within CCL regulations. They also mention that the client in question is usually the aggressor in these altercations with other clients. Staff pointed out an incident that occurred on 2/5/22 where the client in question attacked another client in which they had to call law inforcment and the client in question was booked in juvenile hall.
On 2/16/22 LPA Simien asked clients, “do you feel like there are enough staff to stop physical altercations?”. The clients’ responses were mixed. They responded, “yes, staff put a stop to bullying” and “kind of, staff attempts to stop altercations.”

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations . Therefore, the above allegations are unsubstantiated.

As a result of this visit, there were no title 22 deficiencies observed. Exit interview was conducted and a copy of this report was to Clarissa Joseph, Residential Manager (RM).

SUPERVISORS NAME: Helga Wong
LICENSING EVALUATOR NAME: Paul Simien
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022

LIC9099 (FAS) - (06/04)

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