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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392701163
Report Date: 06/22/2023
Date Signed: 06/22/2023 12:45:21 PM

Document Has Been Signed on 06/22/2023 12:45 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:RCFE CARE & RESPITE HOUSEFACILITY NUMBER:
392701163
ADMINISTRATOR:SANTIAGO, ROLANDOFACILITY TYPE:
740
ADDRESS:663 CHICAGO AVENUETELEPHONE:
(209) 207-4964
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY: 6CENSUS: 3DATE:
06/22/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:09 AM
MET WITH:Rolando SantiagoTIME COMPLETED:
11:10 PM
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On 6/29/23 at approximately 11:00am Licensing Program Analysts (LPAs) Maja Jensen and Jennifer Fain arrived at facility unannounced to conduct a case management. At 8:28am Licensee Santiago called LPA Jensen seeking guidance regarding a client making allegations against another resident. LPAs Jensen and Fain arrived and met with Rolando Santiago and explained the reason for the visit.

LPAs Jensen and Fain interviewed the Licensee who advised that on 6/20/23 Resident 1 (R1) and Resident 2 (R2) were in a common area. R1 and R2 voluntarily embraced and were showing affection with each other in the presence of the Licensee and Staff 1 (S1). On 6/21/23 R1 reported that during the evening of 6/20/23 R2 made unwelcome advance but there was no physical contact. LPA Jensen conducted a prior case management on 6/7/23 involving R1 making allegations regarding sexual advances which were determined to be unsubstantiated by CDPH. It was further determined that R1 has a history of making false allegations.

As a result of the allegation made by R1 for the alleged incident on 6/20/23 the Licensee held a house meeting and obtained statements from all residents. All residents were advised that their service coordinators will be notified. An in-service training was also conducted with staff and night shift staff has increased routine night checks.

LPAs Jensen advised that she will reach out to the service coordinator to discuss some potential interventions such as behavior contracts and counselling. The Licensee and the LPA discussed increasing staffing levels to provide a greater level of supervision between R1 and R2 until additional interventions are implemented. LPA Jensen discussed personal rights with the Licensee and the need to ensure client compatibility when accepting new clients.

No deficiencies are being cited as a result of this visit. An exit interview was conducted and a copy of this
was given to Rolando Santiago.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE: DATE: 06/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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