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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 045001756
Report Date: 07/06/2022
Date Signed: 07/06/2022 02:20:43 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/21/2022 and conducted by Evaluator Jaclyn Avila
COMPLAINT CONTROL NUMBER: 25-AS-20220421095400
FACILITY NAME:COMPASS ROSEFACILITY NUMBER:
045001756
ADMINISTRATOR:KEENE, CLIFFFACILITY TYPE:
740
ADDRESS:2750 SIERRA SUNRISE TERRACETELEPHONE:
(530) 774-2705
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY:48CENSUS: 28DATE:
07/06/2022
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Administrator Cliff KeeneTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
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7
8
9
Facility is overcharging resident
Facility is financially abusing resident
Facility failed to meet resident's needs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
07/06/2022 at about 1:00 PM, Licensing Program Analyst (LPA) Jaclyn Avila, arrived at the facility unannounced to conduct a complaint investigation visit regarding the above listed allegations. LPA met with administrator Cliff Keene and RSD Pomali Thitphaneth and explained the purpose of the visit. Prior to initiating the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N95
This Department has conducted an investigation which included interviews, observations and review of documents, none of which supported the allegations. The investigation revealed that the facility has advocated for the resident and made the required notifications regarding possible financial abuse of a dependent adult.
This agency has investigated the complaint alleging (Facility is overcharging resident, Facility is financially abusing resident, Facility failed to meet resident's needs). We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.
Unfounded
Estimated Days of Completion: 0
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Jaclyn AvilaTELEPHONE: (530) 895-4275
LICENSING EVALUATOR SIGNATURE:

DATE: 07/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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