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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 210102765
Report Date: 09/26/2024
Date Signed: 09/26/2024 10:01:07 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
09/11/2024 and conducted by Evaluator Shannan Hansen
PUBLIC
COMPLAINT CONTROL NUMBER: 21-AS-20240911152523
FACILITY NAME:CEDARS OF MARIN ROSS CAMPUS, THEFACILITY NUMBER:
210102765
ADMINISTRATOR:ANDERSON, STACYFACILITY TYPE:
735
ADDRESS:115 UPPER ROADTELEPHONE:
(415) 454-5310
CITY:ROSSSTATE: CAZIP CODE:
94957
CAPACITY:55CENSUS: 46DATE:
09/26/2024
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Rodric "Rob" Robinson, Dir of Residential ServicesTIME COMPLETED:
10:10 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Illegal eviction
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Shannan Hansen arrived unannounced to deliver complaint findings regarding the allegation listed above and met with Dir of Residential Services, Rodric Robinson.

Illegal eviction- Reporting party alleges the facility evicted client (C1) without providing an explanation or notification. On 9/5/2024 a 30-day notice was emailed to C1’s family, citing a recent incident that the facility believes brings potential risk to C1, other clients in the home and the community. Letter states the facility would like C1 to go home until the issue is “made clearer or resolved in some way.” The following day on 9/6/2024 an email rescinding the 30-day notice was sent to C1’s family. Per Director of Residential Services, C1’s belongings are still in their room. Therefore, the allegation Illegal eviction is Unsubstantiated.

Although the allegation above may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Shannan Hansen
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
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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