Facility Evaluation Report
Licensing Program Analyst (LPA) Vicky Williamson conducted an unannounced case management visit to follow up on incident reports received by Community Care Licensing on 7/25/22, 7/29/22 and 8/17/22. LPA met with Rukhsana Gasque, Licensee and discussed the purpose of the visit.
On 7/25/22, LPA received a self reported incident report from the facility regarding inappropriate interactions between Client 1 (C1) and Client (2). It was reported by Client 3 (C3) that they observed C1 give C2 a kiss on the cheek. Per Licensee, C1 and C2 acknowledged the inappropriate interaction. Staff 1 (S1) was present in the same room with C1 and C2, however did not observe the inappropriate behavior.
On 7/29/22, LPA received a self reported incident report from the facility regarding a client participating in illegal activity at another residence. On 7/27/22, Client 5 (C5) reported the information to Staff (S3). Licensee notified responsible party and all outside agencies.
On 7/29/22, LPA received a self reported incident report from the facility regarding client on client assault. On 7/28/22, it was reported during the transporting of clients, Client 2 (C2) took a cell phone from Client 3 (C3). Client 4 (C4) became upset and and asked C2 to return C3's cell phone. C2 became upset and slapped C4 on the hand. Staff 2 (S2) intervened and the cell phone was returned to C3. C2 and C4 were separated on the van. There were no injuries sustained.
On 8/17/22, Licensee submitted a self reported incident report from the facility not received by LPA prior to today's visit. On 8/10/22, Client 6 (C6) reported to Licensee and staff at the facility that they were assaulted by staff at their primary residence. Per licensee and staff, C6 sustained bruises to their back. LPA's observation of documentation reviewed verified that C6 sustained bruising to their back and elbow. Licensee notified responsible party and all required outside agencies. LPA will follow up with the primary facility where C6 resides. Continued on next page
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction