Senior Care Records.

Complaint Investigation Report

God's Grace, Hayward09/14/2023Licence 015600382

Census20
Date signed09/14/2023 02:57:02 PM
The inspector’s account

R1 stated that S1 told R1 that R1's height is about 5 feet 9 inches and that R1's private part size is 6 inches. R1 further stated that S1 told R1 that since S1 is about 5 feet, the size of S1's private part is 4 inches.

LPA interviewed S1 and S2. S1 denied telling R1 of the size of R1's private part relative to R1's height but stated R1 told S1 about R1's height and he told R1 that R1 is blessed. S1 confirmed he told R1 that he is about 5 feet tall but his private part is not shrinking. S2 confirmed the incident happened and stated hearing the conversation between R1 and S1 about the sizes of their private parts relative to their heights.

Based on i nterviews and record review , the preponderance of evidence has been met, therefore the allegation is found to be substantiated. Deficiency is cited from Title 22 California Code of Regulations, and listed on 9099D. Failure to submit proof of correction by plan of correction due date may result in civil penalty.

Deficiency and plan and proof of correction were discussed with licensee. Licensee has to leave, and authorized James Andrew Cabigon to sign and receive this report.

Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction