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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 345920088
Report Date: 05/14/2025
Date Signed: 05/14/2025 11:48:23 AM

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
05/06/2025 and conducted by Evaluator Cassie Yang
COMPLAINT CONTROL NUMBER: 59-AS-20250506211549
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: 29DATE:
05/14/2025
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Brandy ValenciaTIME COMPLETED:
11:50 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Due to staff's neglect, Resident was physically and verbally abused by another resident.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On May 14, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to investigate the allegation of the complaint. LPA met with Administrator and explained the purpose of the visit.

Allegation: Due to staff's neglect, Resident was physically and verbally abused by another resident.
The Department conducted interviews and file reviews. Based on interview conducted with Administartor, it revealed R1 has had a change in antipsychotic medication which has caused behavioral change. File review revealed facility has been adjusting R1's medication to get R1 back to baseline. Interview conducted with R2 revealed the incident occurred "out of the blue" and that staff intervened immeidately. Based on information above, the Department concluded that the allegation is 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.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Cassie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
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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