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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700070
Report Date: 12/10/2024
Date Signed: 12/10/2024 02:13:12 PM

Unfounded


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
12/09/2024 and conducted by Evaluator Sabrina Calzada
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20241209000714
FACILITY NAME:KIND CONNECTIONFACILITY NUMBER:
342700070
ADMINISTRATOR:DELA PAZ, MA. LOURDESFACILITY TYPE:
740
ADDRESS:8159 WACHTEL WAYTELEPHONE:
(916) 599-0477
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:6CENSUS: 4DATE:
12/10/2024
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Lourdes dela Paz, Administrator TIME COMPLETED:
02:10 PM
ALLEGATION(S):
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Staff pinch a resident while in care.
Staff inappropriately shove a resident while in care.
Staff deny a resident a resident from using their walker.
Staff are mistreating a resident while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a 10-day inspection and met with Lourdes dela Paz, Administrator. Staff, Jovylito Madum, was also present. LPA observed (3) clients present and (1) client return from day program during today's inspection. LPA discussed the allegations with the Administrator, including the first name of the client who the allegations pertain to. The Administrator and staff stated there is not currently a client with this name living at the care home. Also there are no clients who currently use a walker, and all clients are essentially non-verbal. It was also confirmed the police did not visit the care home last night. Staff, Richard Durmol, was contacted by phone today and confirmed the Ombudsman also visited this care home yesterday due to the incorrect address listed.

Based on information obtained, this complaint was inadverently opened under the incorrect facility and findings are UNFOUNDED- An unfounded allegation means that the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview conducted. A copy of this report was left at the facility.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
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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