<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 045002168
Report Date: 11/19/2025
Date Signed: 11/19/2025 02:31:25 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/29/2025 and conducted by Evaluator Kayla Adkison
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20251029124703
FACILITY NAME:FERRER HOME CARE NO. 3FACILITY NUMBER:
045002168
ADMINISTRATOR:MABEL, MAXINEFACILITY TYPE:
735
ADDRESS:86 ARTESIA DRIVETELEPHONE:
(530) 342-9779
CITY:CHICOSTATE: CAZIP CODE:
95973
CAPACITY:6CENSUS: 3DATE:
11/19/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Maxine Mabel, AdministratorTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not properly supervise resident, resulting in resident trespassing onto neighbor's property
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On November 19, 2025, Licensing Program Analyst (LPA) Kayla Adkison arrived at the facility unannounced for the purpose of delivering complaint findings. LPA was greeted by direct care staff and explained the purpose of the visit. Administrator, Maxine Mabel, arrived approxiamtely 10 minutes later. During the visit, there were two (2) staff and three (3) clients present.

During the course of the investigation, LPA made observations, reviewed documents, and conducted interviews with associated parties.

Continued on LIC 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Kayla Adkison
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 59-AS-20251029124703
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: FERRER HOME CARE NO. 3
FACILITY NUMBER: 045002168
VISIT DATE: 11/19/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Allegation: Staff do not properly supervise resident, resulting in resident trespassing onto neighbor's property

It was alleged that a client (C1) had eloped from the facility on to neighboring properties without supervision of facility staff on more than one occasion.

On November 2, 2025, LPA reviewed multiple Ring camera videos which showed C1 on various dates wandering in a neighbor’s yard unsupervised by any facility staff. In these videos, C1 can be seen destroying their own property in the driveway of a neighboring home and taking property from a neighbor’s front porch. The majority of these videos are time stamped between 12:00 Am and 3:00 AM. The earliest of these videos occurred on September 3, 2024, with the most recent being October 25, 2025.

On November 3, 2025, LPA conducted a tour of the facility. It was discovered that C1's bedroom has a door that leads directly to the facility driveway, which is not gated and is not kept locked. LPA interviewed the facility administrator who confirmed the client has eloped from the facility on several occasions without staff supervision. Administrator stated neighbors have brought C1 back to the facility or contacted administrator to let them know C1 was observed in the neighborhood on their own. Administrator further stated that C1 will sometimes wait until the staff on shift is busy assisting another client and will then exit the bedroom door to the driveway to avoid being caught by staff.

On November 11, 2025, LPA reviewed C1's Physician's Report (LIC 602) which indicated C1 was unable to leave the facility unassisted.

Based on observations, document review, and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22), is cited on the attached LIC 9099-D. Exit Interview conducted. A copy of this report and Appeal Rights were provided to Maxine Mabel, Administrator, via email.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Kayla Adkison
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 59-AS-20251029124703
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: FERRER HOME CARE NO. 3
FACILITY NUMBER: 045002168
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/21/2025
Section Cited
CCR
80065(b)(1)
1
2
3
4
5
6
7
80065 Personnel Requirements(b) The licensing agency shall have the authority to require any licensee to provide additional staff whenever the licensing agency determines and documents that additional staff are required for the provision of services necessary to meet client needs. The licensee shall be informed in writing of the reasons for the licensing agency's determination. The following factors shall be taken into consideration in determining the need for additional staff (1) Needs of the particular clients. This is evidenced by:
1
2
3
4
5
6
7
Licensee shall employ and schedule one (1) additional staff during each shift to ensure C1 is properly supervised at all times. Licensee/Administrator shall provide proof of updated facility staff schedule to LPA by end of business 11/21/2025. Should the Licensee choose to "seal" the exterior door on C1's bedroom, this requirement may be reviewed and altered at a later date with approval from CCLD. Licensee shall acquire necessary update facility sketch and fire clearance once the door has been "sealed."
8
9
10
11
12
13
14
Based on observation, record review, and interviews conducted, the licensee/administrator did not provide enough staff to properly provide the services necessary to meet C1's needs, particularly C1's needed level of supervision, which poses an immediate health, safety or personal rights violation to clients in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Kayla Adkison
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3