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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079201001
Report Date: 03/12/2025
Date Signed: 03/12/2025 02:04:54 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/07/2025 and conducted by Evaluator Laura Hall
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250307093040
FACILITY NAME:ROSE'S GARDEN ARF #4FACILITY NUMBER:
079201001
ADMINISTRATOR:ROSA MENJJIVAR NUNESFACILITY TYPE:
735
ADDRESS:2809 LONGVIEW ROADTELEPHONE:
(925) 421-7021
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY:4CENSUS: 4DATE:
03/12/2025
UNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Rosa Menjivar Nunes, AdministratorTIME COMPLETED:
02:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not seek timely medical attention for client
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 3/12/2025 at 12:35pm, Licensing Program Analysts (LPAs), L. Hall and C. Fowler arrived unannounced to conduct the 10-day initial complaint visit and to deliver complaint findings for the allegation above. LPA met with Rosa Menjivar Nunes, Administrator and explained the reason for the visit.

During the course of the investigation the Department conducted interviews with staff, witness, obtained and reviewed records.

Allegation: Staff did not seek timely medical attention for client.

W1 stated during interview that the doctor stated on the after summary visit dated

Continued on LIC9099C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
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 2
Control Number 15-AS-20250307093040
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: ROSE'S GARDEN ARF #4
FACILITY NUMBER: 079201001
VISIT DATE: 03/12/2025
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
Continued from LIC9099.

February 13, 2025, that C1 should be hospitalized through the emergency room (ER) for further evaluation. W1 stated facility did not take C1 to the ER as requested. S1 stated during interview that C1 was seen by the doctor on February 13, 2025, but due to C1's behaviors the doctor suggested that C1 been seen in the ER and hospitalized for further investigations because C1 would need to be sedated. S1 stated staff had to taken C1 to the ER to arrange a visit but there were a lot of people and they left. S1 stated the visit had to be planned because C1 requires consent for special medical treatment. S1 stated on March 5, 2025, C1 was at day program and S1 was advised by a Regional Center staff to take C1 to the ER right away. C1 was taken from the day program to the ER at Sutter Delta Medical Center. S1 then stated C1 was not able to receive any medical treatment due to C1 was not able to receive consent.

Based upon the interviews conducted and information obtained during investigation the above allegation is unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview conducted and a copy of report was given.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2