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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 121372020
Report Date: 04/29/2025
Date Signed: 04/29/2025 10:12:30 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/09/2025 and conducted by Evaluator Christopher Arnhold
PUBLIC
COMPLAINT CONTROL NUMBER: 21-AS-20250109165507
FACILITY NAME:FRYE'S CARE HOMEFACILITY NUMBER:
121372020
ADMINISTRATOR:DELORES FRYEFACILITY TYPE:
740
ADDRESS:2240 FERN STREETTELEPHONE:
(707) 442-2712
CITY:EUREKASTATE: CAZIP CODE:
95503
CAPACITY:58CENSUS: 32DATE:
04/29/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Katelyn FormbyTIME COMPLETED:
10:20 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Medication Mismanagement
Personal Rights
Facility not providing care and supervision
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
At approximately 8:00AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to conduct an investigation into the above allegations. LPA met with Katelyn Formby, interviewed staff and reviewed records. Based on interviews and records reviewed, LPA did not find evidence to support the allegation that staff mismanaged medication. The medication is prepared in the medication room and taken to the residents room. Staff stay with resident to ensure medication is taken, then return the medication cup to the medication room. LPA inspected various resident rooms and did not observe any evidence of medications. Based on interviews conducted, LPA did not find evidence that staff violated residents personal rights. Residents diagnosed with dementia retain the personal right to engage in sexual behaviors and spend time with those they choose to be with. Staff are aware and observant for hostile actions between residents to ensure safety. Based on records reviewed and interviews conducted, LPA did not find evidence to support the allegation that facility is not providing care and supervision. Resident records show resident diet orders are for a regular diet with thin liquids. Oxygen orders are on an as needed basis. Hospice orders show to elevate extremities, but resident is able to move legs on an off the bed. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2025
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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