Senior Care Records.

Facility Evaluation Report

North Star #1, Vacaville10/07/2025Licence 486803802

Capacity5
Date signed10/07/2025 12:37:47 PM
Name of licensing program analystEthel Contreras
Name of licensing program managerKimberley Mota
The inspector’s account

At approximately 11:20, Licensing Program Analyst (LPA) Contreras conducted a case management visit and met with administrator(admin) Jacqueline Hicks. The purpose of the case management visit was to obtain additional information regarding incident and SOC341 reports that have been self reported by the facility.

On 8/19/2025 and 8/22/2025 LPA received incident reports and SOC341 involving client(C1) and staff(S1) alleged physical abuse. LPA conducted visit on 8/26/2025 and arrived today to receive updates regarding the internal investigation that facility is conducting. Per admin, internal investigation is still ongoing and staff has not returned to facility to work effective 9/05/2025.

LPA received second report on 8/22/2025 and SOC341 involving (C2) alleged physical abuse by staff (S2) per incident report. Per admin, internal investigation is still ongoing and staff is still on administrative leave as of 8/22/2025.

LPA received additional SOC341 on 9/11/2025 regarding (C1) alleged physical abuse from (C1) previous placement. Admin notified OPS and are currently identifying details of allegation and conducting an internal investigation.

LPA received Incident report on 9/29/2025 regarding (C1) alleged physical abuse from staff (S3). Per admin staff has been cleared from allegation and has returned to work.

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