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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157209211
Report Date: 07/13/2023
Date Signed: 07/13/2023 03:47:19 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, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/05/2023 and conducted by Evaluator Darius Williams
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20230505164533
FACILITY NAME:PATHWAY HOME CAREFACILITY NUMBER:
157209211
ADMINISTRATOR:JOHNSON, JONATHANFACILITY TYPE:
740
ADDRESS:410 LANSING DRIVETELEPHONE:
(661) 836-5705
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY:6CENSUS: 6DATE:
07/13/2023
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:House Manager, Jessica VasquezTIME COMPLETED:
11:50 AM
ALLEGATION(S):
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Staff hit resident with a towel
Staff did not provide care to resident
INVESTIGATION FINDINGS:
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Liceninsg Program Analyst (LPA) Darius Williams conducted an unannounced follow up visit. LPA Williams met with House Manager, Jessica Vasquez. Administrator, Johnathan Johnson was reached by phone.

LPA Williams conducted interviews, record review, and observations.

According to Resident 1 (R1), Staff 1(S1) hit them with a towel three times and took aproximately 30 minutes to assist with pulling up their pants. LPA asked R1 if there was anyone who observed the event and R1 reported, "No one else saw anything because they were in their rooms." LPA asked if there had been prior incidents or concerns with S1, which R1 responded, "No."

According to Staff 1 (S1), R1 became angry and aggressive during toileting. Staff left the restroom out of concern for their safety for approximately 5 minutes to allow R1 to calm down.

*Continued on LIC 9099-C*
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Darius Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2023
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 2
Control Number 24-AS-20230505164533
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: PATHWAY HOME CARE
FACILITY NUMBER: 157209211
VISIT DATE: 07/13/2023
NARRATIVE
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S1 returned to the restroom and as they did R1 was standing at the door yelling and cursing (S1 could not remember exact words). S1 assisted R1 by pulling up their pants to the waist. S1 reported having a towel draped over their shoulder, but they did not hit R1 with it.

Resident 2 (R2) reported visually witnessing some of the event from right outside the threshold of their bedroom door. LPA could see the bathroom from where R2 reported observing the event. R2 reported hearing R1 yell at S1 and use curse words, which they could not remember exactly. After unknown amount of time R2, moved outside the threshold of their bedroom door and observed the event, which they did not see S1 strike R1 with a towel. R2 mentioned that they do not associate with R1 because R1 yells at people if they do not get their way. R2 also mentioned they were concerned for S1 safety due to the yelling from R1.

Resident 3 did not observe the event, but reporting hearing R1 yell at staff.

Bakersfield Police Department responded to the incident and statements from all parties are similar to what was provided to the LPA.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation staff hit resident with a towel and staff did not provide care to resident is UNSUBSTANTIATED.

An exit interview was conducted and a copy of this report will be provided via e-mail.
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Darius Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2023
LIC9099 (FAS) - (06/04)
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