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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 340310966
Report Date: 01/25/2024
Date Signed: 01/25/2024 01:24:50 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 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
01/25/2024 and conducted by Evaluator Talwinder Bains
COMPLAINT CONTROL NUMBER: 59-AS-20240125102540
FACILITY NAME:TAYLOR HOMEFACILITY NUMBER:
340310966
ADMINISTRATOR:TAYLOR, FILOMENAFACILITY TYPE:
740
ADDRESS:3832 MILTON WAYTELEPHONE:
(916) 332-1946
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY:6CENSUS: 5DATE:
01/25/2024
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Filomena TaylorTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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RSO who is not a client allegedly resides, is present and/or has contact that may pose a risk to the health and safety of clients in care.
INVESTIGATION FINDINGS:
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On 01/25/24, Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced to deliver complaint findings into the allegations listed above and met with Administrator, Filomena Taylor.

“Based on evidence obtained during the course of this investigation, the Department has Substantiated that an individual who has been convicted of a crime for which registration Assignment of the investigation: as a Registered Sex Offender (RSO) is required, is residing at the facility or has presence/contact that may pose a risk to the health and safety of the client(s) in care at a facility licensed by the department. This is a factual determination based on all the facts and circumstances of the case.” Based on this information, citation has been issued per CCL, Title 22 regulations.

Exit interview conducted. Appeal Rights and copy of the report provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2024
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 59-AS-20240125102540
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: TAYLOR HOME
FACILITY NUMBER: 340310966
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/26/2024
Section Cited
CCR
87356(a)(1)
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87356-Criminal Record Exemption (a) The Department shall notify a licensee to act immediately to terminate the employment of, remove from the facility licensee shall comply with the notice.... (1)Any person who has been convicted of, or is awaiting trial for, a sex offense against a minor; this requirement is not met as evidenced by;
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Licensee/Administrator shall ensure that No individual who has been convicted of a crime for which registration as a Registered Sex Offender (RSO) is required, is residing at the facility or has presence/contact with clients/ residents in any manner.
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Based on evidence obtained during the course of this investigation, the Department has Substantiated that an individual who has been convicted of a crime for which registration as a Registered Sex Offender (RSO) is required, is residing at the facility or has presence/contact that pose immediate a risk to the health and safety of the client(s) in care .
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Civil Penalties shall be assessed if POC requirements are not met.
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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: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2