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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800086
Report Date: 09/27/2023
Date Signed: 09/27/2023 10:41:52 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, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/16/2020 and conducted by Evaluator Janira Arreola
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20200316140401
FACILITY NAME:CALIFORNIA HOME FOR THE ADULT DEAF (CHAD)FACILITY NUMBER:
331800086
ADMINISTRATOR:CASTRO, MICHAELFACILITY TYPE:
740
ADDRESS:3615 CROWELL AVETELEPHONE:
(951) 324-1601
CITY:RIVERSIDESTATE: CAZIP CODE:
92504
CAPACITY:6CENSUS: 6DATE:
09/27/2023
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Licensee, Danny BarrettTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff speaks inappropriately towards client while in care
Staff retaliated against client while in care
INVESTIGATION FINDINGS:
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On 9/27/2023, Licensing Program Analyst (LPA) Janira Arreola, conducted an unannounced visit to the facility in order to investigate the above allegations. LPA was accompanied by a Community Care Licensing approved ASL interpreter to assist LPA's communications with facility staff and residents. LPA met with Licensee, Danny Barrett, who was informed of the purpose of the visit. During the visit, LPA conducted interviews, documented observations, and conducted records reviews.

It was alleged that "Staff speaks inappropriately towards client while in care". Allegedly Staff#1 (S1) had yelled at Resident #1(R1). LPA interviewed staff who denied the allegation. LPA interviewed resident who stated they would not recall the incident. Therefore, the allegation was unsubstantited.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023
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 18-AS-20200316140401
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: CALIFORNIA HOME FOR THE ADULT DEAF (CHAD)
FACILITY NUMBER: 331800086
VISIT DATE: 09/27/2023
NARRATIVE
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Regarding allegation "Staff retaliated against client while in care", it was alleged that S1 had interfered with R1's sleeping schedule as retaliation for issuing a complaint with Community Care Licensing. LPA interview staff who denied the allegation. LPA interviewed resident who stated they could not recall the incident occurring. Therefore this allegation is also unsubstantiated.

Findings that are unsubstantiated mean that although the allegation is valid, the preponderance of the evidence standard has not been met.

An exit interview was conducted with Licensee, Danny Barrett, where this report and licensee rights were reviewed and provided to them.
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2