045002773-3-23-2023-25-AS-KHOS-CQSMP4-20230411094631

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 045002773
Report Date: 03/23/2023
Date Signed: 03/23/2023 11:13:50 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/22/2022 and conducted by Evaluator Kerry Hiratsuka

COMPLAINT CONTROL NUMBER: 25-AS-20221222131246

FACILITY NAME:	ROSELEAF OROVILLE		FACILITY NUMBER:	045002773
ADMINISTRATOR:	FARMER, AMBER		FACILITY TYPE:	740
ADDRESS:	1900 20TH ST		TELEPHONE:	(530) 538-8200
CITY:	OROVILLE	STATE: CA	ZIP CODE:	95965
CAPACITY:	60	CENSUS: 30	DATE:	03/23/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Amber Farmer and Diania Bingham		TIME COMPLETED:	11:25 AM

ALLEGATION(S):

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Facility is not properly addressing rodent issue

INVESTIGATION FINDINGS:

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LPA Hiratsuka, conducted this unannounced complaint visit to deliver the findings.

LPA has spoken with Administrator, a couple of staff, and received a copy of the pest control company. The facility has addressed the issue as soon as it was brought to the attention to management. The pest control company checks once a month and whenever they are called. They were here this morning before LPA arrived.

The allegation is unfounded. A finding of unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. Exit interview conducted.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Lauren Crocker	TELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Kerry Hiratsuka	TELEPHONE: (916) 591-0210
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023

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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