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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 397005376
Report Date: 07/29/2025
Date Signed: 07/29/2025 01:36:04 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CRP RO, 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
05/30/2025 and conducted by Evaluator Connie Goldie
COMPLAINT CONTROL NUMBER: 23-CR-20250530084149
FACILITY NAME:LABARA FAMILY CARE HOMEFACILITY NUMBER:
397005376
ADMINISTRATOR:ANTHONY L. JOHNSONFACILITY TYPE:
730
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:4CENSUS: DATE:
07/29/2025
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Hector Vega Facility Manager
Anthony Johnson Administrator		TIME COMPLETED:
01:40 PM
ALLEGATION(S):
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Facility staff do not maintain accurate records for minors in care

INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Connie Goldie arrived at the facility to conduct an unannounced complaint investigation inspection on 07/29/2025 at 12:45PM. LPA Goldie spoke with Hector Vega, Facility Manager and Anthony Johnson Administrator to discuss the findings of the complaint investigation and allegation stated above. LPA Connie Goldie conducted this investigation.The initial 10-day complaint investigation inspections were conducted by LPA Goldie at the facility on 06/05/2025. LPA Goldie reviewed youth file (C1), conducted a walk-through of the facility inside and outside and interviewed staff, S1. LPA attempted to interview C1 who has limited verbal communication. LPA Goldie obtained the following documentation: Client roster, May 2025 staff schedule, C1’s face sheet, Individualized Program Plan, May 2025 bathroom logs, and g-tube removal documentation. During the investigation, eight confidential interviews were conducted between 06/05/2025 and 07/25/2025.


Continued on LIC9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jodean Hall
LICENSING EVALUATOR NAME: Connie Goldie
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2025
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 5
Control Number 23-CR-20250530084149
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CRP RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: LABARA FAMILY CARE HOME
FACILITY NUMBER: 397005376
VISIT DATE: 07/29/2025
NARRATIVE
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Regarding the allegation, “Facility staff do not maintain accurate records for minors in care”, Record review conducted on 06/05/2025 of C1’s file had missing required documentation, C1’s current IPP and face sheet were not included in the file and were supplied to LPA on 06/06/2025 via email. A witness (W1) stated that they are “asked for information, such as correspondence about a new doctor or insurance change, that has already been provided weeks and even months afterwards.” A Regional Center staff stated that record requests are late and there is concern about organization. Two of five staff members stated that C1’s documentation is put in C1’s bedroom or the office. One staff member stated that an IPP has been misplaced in another client’s file. Two staff members stated that client documentation is placed in youth files.

Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 5 Article 6 84070(b) Children’s Records are being cited on the attached LIC 9099D.”

An exit interview was conducted. A copy of all reports and appeal rights were discussed and provided to the facility.

SUPERVISORS NAME: Jodean Hall
LICENSING EVALUATOR NAME: Connie Goldie
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 23-CR-20250530084149
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CRP RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LABARA FAMILY CARE HOME
FACILITY NUMBER: 397005376
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/29/2025
Section Cited
CCR
84070(b)
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Children's Records 84070 (b) The following information regarding the child shall be obtained and maintained in the child's record:

This requirement was not met as evidenced by:
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Administrator will hold training regarding documentation, children's files and location with staff and present a copy of signed agenda to CCL by 08/29/2025.
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Based on observation, interview, and record review, the facility did not comply with the section cited above as C1's file was missing required documentation on 06/05/2025, which poses/posed a potential health, safety or personal rights risk to persons in care.
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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: Jodean Hall
LICENSING EVALUATOR NAME: Connie Goldie
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CRP RO, 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
05/30/2025 and conducted by Evaluator Connie Goldie
COMPLAINT CONTROL NUMBER: 23-CR-20250530084149

FACILITY NAME:LABARA FAMILY CARE HOMEFACILITY NUMBER:
397005376
ADMINISTRATOR:ANTHONY L. JOHNSONFACILITY TYPE:
730
ADDRESS:3954 BLACK BUTTE CIRCLETELEPHONE:
(209) 227-7234
CITY:STOCKTONSTATE: CAZIP CODE:
95209
CAPACITY:4CENSUS: DATE:
07/29/2025
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Hector Vega, Facility Manager
Anthony Johnson, Administrator		TIME COMPLETED:
01:40 PM
ALLEGATION(S):
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Facility staff are not meeting minors personal hygiene needs
Facility staff are not meeting minors toileting needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Connie Goldie arrived at the facility to conduct an unannounced complaint investigation inspection on 07/29/2025 at 12:45 PM. LPA Goldie spoke with Hector Vega, Facility Manager and Anthony Johnson, Administrator, to discuss the findings of the complaint investigation and allegations stated above. LPA Connie Goldie conducted this investigation.The initial 10-day complaint investigation inspection was conducted by LPA Goldie at the facility on 06/05/2025. LPA Goldie reviewed youth file (C1), conducted a walk-through of the facility inside and outside and interviewed staff, S1. LPA attempted to interview C1 who has limited verbal communication. LPA Goldie obtained the following documentation: Client roster, May 2025 staff schedule, C1’s face sheet, Individualized Program Plan, May 2025 bathroom logs, and g-tube removal documentation. During the investigation, eight confidential interviews were conducted between 06/05/2025 and 07/25/2025.

Continued on LIC9099C

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jodean Hall
LICENSING EVALUATOR NAME: Connie Goldie
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 23-CR-20250530084149
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CRP RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: LABARA FAMILY CARE HOME
FACILITY NUMBER: 397005376
VISIT DATE: 07/29/2025
NARRATIVE
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The Department investigated the allegations, “Facility staff are not meeting minor’s personal hygiene needs” and “Facility staff are not meeting minor’s toileting needs.” Five of five staff corroborate that youth in care are showered daily, 1-2 times a day and that C1 showered in the morning and in the evening. The staff were consistent in statements of C1’s personal hygiene routine process which included monitored showering with prompting, teeth brushing, applying lotion and self-dressing by C1.

It was stated that C1 preferred showers and did shower both in the stand-alone shower and the bathtub with a shower and that staff would ensure that the water temperature was warm. C1 would communicate if the temperature was too cold or too warm but, would play with the knob afterwards. C1 is incontinent but was in the process of toilet training and did have many accidents. Staff collaborated that C1 was checked every 30- 60 minutes and was cleaned and changed as needed. If C1 had an accident, it was stated that he would shower afterwards, and clothes/ sheets were laundered. C1 was unable to be interviewed due to limited verbal skills but, was observed to be wearing clean clothes, and well-groomed on unannounced visit on 06/05/2025. Record review of bathroom logs are consistent with staff statements. Regional Center staff also communicate C1’s hygiene needs appeared to be met when they visited. Based on the investigation, records reviewed, and interviews conducted, the complaint finding is UNSUBSTANTIATED at this time meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted. A copy of all reports and appeal rights were discussed and provided to the facility.
SUPERVISORS NAME: Jodean Hall
LICENSING EVALUATOR NAME: Connie Goldie
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5