502700165-8-9-2023-27-AS-SRIN-CURTWJ-20230816150536

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 502700165
Report Date: 08/04/2023
Date Signed: 08/09/2023 11:03:27 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/10/2023 and conducted by Evaluator Albert Johnson

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20230510114020

FACILITY NAME:	PRESTIGE CARE CENTER LLC		FACILITY NUMBER:	502700165
ADMINISTRATOR:	MCNEAL, TANISHA		FACILITY TYPE:	735
ADDRESS:	474 SUNDAY DR		TELEPHONE:	(209) 443-7707
CITY:	TURLOCK	STATE: CA	ZIP CODE:	95382
CAPACITY:	6	CENSUS: 6	DATE:	08/04/2023
		UNANNOUNCED	TIME BEGAN:	10:46 AM
MET WITH:	Tanisha Nc Neil		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Facility staff handled client in a rough manner

INVESTIGATION FINDINGS:

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LPA Albert Johnson arrived to the facility unannounced to deliver findings. LPA met with Staff and explained the purpose of the visit. Later LPA was joined by Tanisha Mc Neal - Administrator.

Based on interviews with day program staff and statements provided by the care home staff, R1 has a history of refusing to get off of the bus at the facility and at the day program. As a result of these interviews and statements the department is unable to determine if R1 was handled in rough manner. Day program staff confirmed that the incident on the 9th of may was not the norm for R1 being dropped off and the statement from the care home confirmed that they did have an incident of refusal that day, but it was not out of the norm for R1 to be persuaded to get out of the van.

Continued

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023

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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Control Number 27-AS-20230510114020

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

FACILITY NAME: PRESTIGE CARE CENTER LLC	FACILITY NUMBER: 502700165
	VISIT DATE: 08/04/2023

NARRATIVE

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R1 is attending a activity center for his day program and resides in a level 4-I care home with a behavior plan to assist R1 with maladaptive behaviors including refusals to get on the bus or get off of the bus. R1 placement at the day program present an issue with continuity of programming with a behavior component missing.

Interviews with the Day program staff confirmed that R1 is well taken care of and he always has on clean clothes and has great lunches when arriving to the program from the care home.

They have no concerns with the level of care that R1 is receiving and feel that R1 is thriving in his current environment. The day program staff were not concerned with the safety of R1 then or at anytime.
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Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview held and copy of report provided to administrator

SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023

LIC9099 (FAS) - (06/04)

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