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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366400636
Report Date: 05/30/2023
Date Signed: 05/30/2023 09:05:10 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 600
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/14/2022 and conducted by Evaluator Adaleyci Caballero
PUBLIC
COMPLAINT CONTROL NUMBER: 19-CR-20220614133037
FACILITY NAME:BERHE GROUP HOME INC.FACILITY NUMBER:
366400636
ADMINISTRATOR:JUDY G BERHEFACILITY TYPE:
733
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:6CENSUS: 6DATE:
05/30/2023
UNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Lead Staff- Cynthia SanchezTIME COMPLETED:
09:15 AM
ALLEGATION(S):
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Staff hit client.
INVESTIGATION FINDINGS:
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On May 30, 2023 at 8:25 AM, Licensing Program Analyst (LPA) Adaleyci Caballero met with Berhe Group Home Inc. Lead Staff Cynthia Sanchez to discuss the investigative findings for the above stated allegation involving a client in the facility. On June 23, 2022, at 2:10 PM, LPA Belinda Torres initiated the investigation at the facility and a safety inspection was conducted. There were no immediate hazards observed. During the visit, LPA B. Torres interviewed one Client (C1). On March 19, 2023, LPA A. Caballero visited the facility for additional interviews; LPA A. Caballero interviewed three Clients (C2, C3, C4) and one Staff (S2). Staff #1 (S1) was not interviewed due to no longer working at the facility and there was no current contact information. LPA A. Caballero interviewed Chief Operations Officer (COO) Aaron Ramsey.


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Abdoulaye Traore
LICENSING EVALUATOR NAME: Adaleyci Caballero
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023
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 4
Control Number 19-CR-20220614133037
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 600
RIVERSIDE, CA 92501
FACILITY NAME: BERHE GROUP HOME INC.
FACILITY NUMBER: 366400636
VISIT DATE: 05/30/2023
NARRATIVE
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On June 14, 2022, Community Care Licensing received information alleging that a staff hit a client. It was specifically alleged that S1 smacked C1’s hand when trying to get out of a door. A confidential interview described the “smack” as more of a tap and it was unknown if it was an accident or not.  Confidential interviews reported that all staff are nice. COO did not have concerns about the care from staff.

Based on confidential interviews, the allegation that a S1 hit a C1 in care may have occurred, however, it is not supported or proven by evidence. Therefore, this allegation is unsubstantiated at this time.
An exit interview was conducted and a copy of this report and appeal rights were reviewed and provided to Lead Staff Cynthia Sanchez

SUPERVISORS NAME: Abdoulaye Traore
LICENSING EVALUATOR NAME: Adaleyci Caballero
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4