Senior Care Records.

Complaint Investigation Report

Good Samaritan Residential Care Facility, Hayward07/03/2024Licence 019200020

Census6
Date signed07/03/2024 11:30:21 AM
The inspector’s account

019200020-7-3-2024-15-AS-KHOS-D9FJVW-20240925072349

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1515 CLAY STREET, STE. 310

This is an official report of an unannounced visit/investigation of a complaint received in our office on

06/25/2024 and conducted by Evaluator Kelly Nguyen

COMPLAINT CONTROL NUMBER: 15-AS-20240625091924

Client was inappropriately touched by staff

Licensing Program Analyst (LPA) Kelly Nguyen arrived unannounced to conduct investigation on the above allegation. LPA met with staff Ellen Jovero; LPA explained the purpose of the visit. Administrator Franklin Bautista later arrived.

At 10:25 am, LPA interviewed S1, S2, C1, and CM Regional of the East Bay (RCEB). C1 was able to respond to LPA questions. When asked C1 deny that C1 was being touch inappropriately by facility staff. Based on an interview with C1, C1 states that “NO…no staff touch me inappropriately. No staff abuse me...but sometime I don’t want to stay here. I don’t like it here. I want to go with my mom". LPA interviewed S1, S2 and CM all stated that C1 tend to make false statement about the facility staff.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated.

A exit interview conducted, and a copy of this report provided via email.

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