385600401-12-4-2024-14-AS-KHOS-DC2JLS-20241217060911

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 385600401
Report Date: 12/04/2024
Date Signed: 12/04/2024 03:40:11 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/25/2024 and conducted by Evaluator Dominic Tobola

COMPLAINT CONTROL NUMBER: 14-AS-20240925133534

FACILITY NAME:	BYXBEE HOME		FACILITY NUMBER:	385600401
ADMINISTRATOR:	MARIA JASMIN NELSON		FACILITY TYPE:	740
ADDRESS:	383 BYXBEE STREET		TELEPHONE:	(415) 586-4663
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94132
CAPACITY:	4	CENSUS: 3	DATE:	12/04/2024
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Jasmine Maria Nelson, Administrator		TIME COMPLETED:	03:55 PM

ALLEGATION(S):

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Facility staff do not treat clients with dignity or respect
Facility staff hit clients
Staff are not responding when clients call for assistance

INVESTIGATION FINDINGS:

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On 12/4/2024, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of delivering complaint investigation findings and was greeted by Administrator, Jasmine Nelson. LPA toured the facility, interviewed staff, residents and outside parties, reviewed resident records and made observations during the course of the investigation.

Complaint alleges facility staff do not treat clients with dignity or respect with staff yelling at resident/victim (R1) or speaking in an inappropriate manner. Based upon interviews with residents (R1, R2 & R3), staff (S2) and Golden Gate Regional Center Service Coordinator (SC1), LPA found inconsistent statements with no indications of staff speaking to residents in demeaning manner. Upon further interview with SC1, it was found that R1 may misinterpret social interactions creating another primary behavior of false accusations. SC1 and facility practice social skills and coaching with R1 for improved independence and interpreting social interactions. Upon review of R1’s Behavioral Support Plan dated 1/18/2024, it is indicated that staff are to conduct teaching methods of appropriate conversation with R1, including the phrases; “what do you think about” or “have you ever” in order to increase R1’s comprehension and understanding of circumstances that R1 may misinterpret. R1’s behaviors include false accusations.

Continued onto LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Andrea Medlin
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2024

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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Control Number 14-AS-20240925133534

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: BYXBEE HOME	FACILITY NUMBER: 385600401
	VISIT DATE: 12/04/2024

NARRATIVE

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In addition, LPA acquired a voice recording conversation between resident R1 and Administrator. Upon review of the recording with SC1, it was found that Administrator is speaking with R1 in a stern manner and repeating a question “when did you ever go without money?” to R1. R1 appears to be soft spoken in the recording. However, SC1 interpreted the interaction as a statement of facts, with the Administrator providing a coaching moment to R1. LPA found that the language and question used in the conversation between R1 and the Administrator is line with R1’s behavior plan. Due to contradicting information gathered and a lack of corroborating evidence from several interviews and records gathered, the allegation is found to be unsubstantiated.

Complaint alleges facility staff hit clients. Based upon interviews with residents (R1, R2 & R3) and staff (S2) there were inconsistent statements or information of staff hitting resident (R2). R2 also indicated that they had not been hit or physically mistreated by staff. Upon interview with Golden Gate Regional Center Service Coordinator (SC1), LPA found that SC1 had never observed or received statements or indications from R1 or any other residents of residents being hit by staff. Due to contradicting information gathered and a lack of corroborating evidence, the allegation is found to be unsubstantiated.

Complaint alleges staff are not responding when clients call for assistance. Based upon interviews with residents (R1, R2 & R3) and staff (S2) LPA received inconsistent information regarding staff providing appropriate assistance. R2 & R3 reported no concerns and stated that staff provide care and respond timely. R1 indicated that they have not been ignored by staff but have had to wait several minutes for a assistance. All resident statements are contradicting from allegation of staff not responding, therefore the allegation is found to be unsubstantiated.

A finding that the complaint allegations, facility staff do not treat clients with dignity or respect, facility staff hit clients & staff are not responding when clients call for assistance are unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

SUPERVISORS NAME: Andrea Medlin
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2024

LIC9099 (FAS) - (06/04)

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