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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 345920088
Report Date: 02/07/2025
Date Signed: 02/07/2025 04:08:58 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
01/30/2025 and conducted by Evaluator Cassie Yang
COMPLAINT CONTROL NUMBER: 59-AS-20250130103108
FACILITY NAME:VISTA ESPERANZAFACILITY NUMBER:
345920088
ADMINISTRATOR:VALENCIA, BRANDYFACILITY TYPE:
740
ADDRESS:5240 JACKSON STREETTELEPHONE:
(415) 590-0579
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY:54CENSUS: 23DATE:
02/07/2025
UNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Brandy ValenciaTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Staff withhold residents money.
Facility does not provide safe furniture for residents to sit.
INVESTIGATION FINDINGS:
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On February 7, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to open and deliver the allegations of the complaint. LPA met with Administrator and explained the purpose of the visit.

Throughout the investigation, LPA conducted interview, file review, audit and observations of the facility. LPA obtained a copy of Facility Money Management policy and R1-R5's LIC 405 Record of Client's/Resident's Safeguard Cash Resources.

LPA has determined the allegations cited above are unfounded.

Please continue on LIC 9099-C.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Cassie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025
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-20250130103108
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: VISTA ESPERANZA
FACILITY NUMBER: 345920088
VISIT DATE: 02/07/2025
NARRATIVE
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LIC 9099-C

Allegation: Staff withhold residents money.

The Department conducted interview, audit and file review of the allegation. Based on interview, Administrator stated residents in care are given Personal and Incidental (P & I) money from their conservator. The monthly P & I is broken up to small increments as an incentive when good behavior is conducted throughout the week. Cash audit was conducted for R1, R2, R3, R4 and R5. Cash audit was aligned with the file review of resident's safeguard cash resource records. File review revealed money was distributed to residents in care multiple times for the month of January and February.

Allegation: Facility does not provide safe furniture for residents to sit.

The Department conducted a tour of the facility to observe the following allegation. Based on observation, LPA observed the clinical offices and the TV lounge room to have chairs for residents in care. LPA observed the following chairs are lower cushioned. The chairs observed appears to be safe and not a danger to residents in care. Additionally, LPA observed four-legged chairs to be available in the conference room, waiting room, dining room and patio for residents in care. LPA observed the facility to be clean, sanitary and in good repair for residents in care.

Based on information above, the Department concluded that the allegations are unfounded. A finding that an allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

No deficiencies cited.

Exit interview was conducted.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Cassie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2