045920055-5-21-2025-59-AS-LCRR-DH6PC2-20250530111113

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 045920055
Report Date: 05/21/2025
Date Signed: 05/21/2025 01:07:52 PM

Unsubstantiated

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
04/01/2025 and conducted by Evaluator Rebecca Knight

COMPLAINT CONTROL NUMBER: 59-AS-20250401151429

FACILITY NAME:	MONTE VISTA		FACILITY NUMBER:	045920055
ADMINISTRATOR:	WEBSTER, SIMONIE		FACILITY TYPE:	735
ADDRESS:	1262 14TH STREET		TELEPHONE:	(916) 624-7800
CITY:	OROVILLE	STATE: CA	ZIP CODE:	95965
CAPACITY:	12	CENSUS: 12	DATE:	05/21/2025
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Khrista Carrasco-Perez - care staff		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Client's personal rights being violated. - UNSUBSTANTIATED
Client's belongings are being stolen. - UNSUBSTANTIATED

INVESTIGATION FINDINGS:

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05/21/2025 12:00 PM Licensing Program Analyst (LPA) Rebecca Knight, made an unannounced visit to the facility and met with care staff Khrista Carrasco-Perez. Administrator Jessie Boothe gave LPA verbal authorization to deliver this report with Ms.Carrasco. The purpose of this visit was to deliver the results of a complaint investigation.

During the course of the investigation LPA conducted interviews and reviewed documents.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

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-20250401151429

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: MONTE VISTA	FACILITY NUMBER: 045920055
	VISIT DATE: 05/21/2025

NARRATIVE

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Client's personal rights being violated.- UNSUBSTANTIATED

It was reported that Client 1 (C1) has been physically pushed by the shoulder by Client 2 (C2), there are threats of hitting, and racial slurs. It was alleged that C1 was yelled at by Staff 1 (S1) and commanded to leave by Staff 2 (S2).

Client 1 stated C2 has pushed me out of the way before but I don’t worry about them.

During staff interviews it was learned that C1 has indicated to staff that other clients who attend the Wellness Center with C1 have used racial slurs against C1, never in the facility. According to staff, C1 has not reported that physical abuse has occurred anywhere.

Administrator stated that C1 has not complained of any physical abuse or racial slurs being used toward them in the facility.

This allegation is unsubstantiated.

Continued on LIC9099-C

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 59-AS-20250401151429

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: MONTE VISTA	FACILITY NUMBER: 045920055
	VISIT DATE: 05/21/2025

NARRATIVE

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Client's belongings are being stolen. - UNSUBSTANTIATED

It was reported that Client 1 (C1) was missing tobacco.

LPA reviewed the facility’s cigarette schedule which states that smoking times are every 2 hours starting at 6:00 AM through 6:00 PM and at bedtime.

C1 stated they are trying to quit smoking and have cut down. C1 thought someone had thrown it away. C1 stated the facility fixed that and now have C1 roll them in the office and now less is being used.

Staff stated that C1 had complained that they were missing tobacco. C1 now comes into the office and rolls their cigarettes for the day in front of staff.

Administrator stated that C1 did say that their tobacco had been less than what they expected. Staff hands C1 their tobacco (C1 rolls their own cigarettes) and C1 brings it back when they are done. The facility does discourage sharing because it causes issues but staff can’t stop the clients from sharing.

This allegation is unsubstantiated.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are UNSUBSTANTIATED.

No deficiencies cited. Exit interview conducted and a copy of the report was provided to administrator Jessie Boothe.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

LIC9099 (FAS) - (06/04)

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