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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 216800881
Report Date: 05/14/2025
Date Signed: 05/14/2025 01:55:15 PM

Substantiated


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
01/13/2025 and conducted by Evaluator Anthony Loera
COMPLAINT CONTROL NUMBER: 21-AS-20250113121832
FACILITY NAME:SAN LUIS HOUSEFACILITY NUMBER:
216800881
ADMINISTRATOR:KAYLA HOTCHKISSFACILITY TYPE:
735
ADDRESS:396 SAN LUIS WAYTELEPHONE:
(415) 525-1082
CITY:NOVATOSTATE: CAZIP CODE:
94945
CAPACITY:6CENSUS: 6DATE:
05/14/2025
UNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Manager Program Operations, Kayla HotchkissTIME COMPLETED:
02:10 PM
ALLEGATION(S):
1
2
3
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5
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9
Facility staff did not prevent clients from eloping
INVESTIGATION FINDINGS:
1
2
3
4
5
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7
8
9
10
11
12
13
On 05/14/2025, Licensing Program Analyst (LPA) Loera met with Manager Program Operations, Kayla Hotchkiss to deliver complaint findings for the allegation “Facility staff did not prevent clients from eloping”. During the investigation, LPA reviewed records, conducted interviews, and made observations.

Department review shows this allegation was addressed in complaint 21-AS-20240321132852 and was substantiated on 06/19/2024. Therefore this allegation cannot be recited.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Anthony Loera
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
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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