216803982-3-25-2022-21-AS-BMOS-CD8MVP-20220406095702

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 216803982
Report Date: 03/25/2022
Date Signed: 03/25/2022 12:02:27 PM

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
12/31/2021 and conducted by Evaluator Carla Fernandes-Goes

PUBLIC

COMPLAINT CONTROL NUMBER: 21-AS-20211231101126

FACILITY NAME:	ANTON POINTE, THE		FACILITY NUMBER:	216803982
ADMINISTRATOR:	ODIWE, CLEDA M.		FACILITY TYPE:	740
ADDRESS:	1470 SOUTH NOVATO BLVD.		TELEPHONE:	(415) 897-1055
CITY:	NOVATO	STATE: CA	ZIP CODE:	94947
CAPACITY:	10	CENSUS:	DATE:	03/25/2022
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Cleda Odiwe - Licensee / Administrator		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Unlawful Eviction

INVESTIGATION FINDINGS:

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The Department conducted a complaint investigation regarding the allegation listed above. Licensing Program Analyst Fernandes-Goes arrived unannounced for the purpose of closing the investigation and met with Cleda Odiwe.

On January 6, 2022, LPA Fernandes-Goes toured the facility; conducted interviews; acquired documentation; and made observations of the facility. During tour of the facility with Cleda Odiwe licensee/administrator, interviews with resident R1, staff, and family member on 1/6/22 and 3/19/22; and documentation review, LPA learned that facility had accept a Kaiser placement of resident R1 on 11/12/21 and Kaiser is supposed to be making payments to facility. Facility staff stated that has spoken with resident R1 family member regarding Kaiser placement, payments, and if family still wants resident to stay after 3 months stipulated by Kaiser, however; has never spoken regarding eviction. (Cont. LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Bethany Moellers	TELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Carla Fernandes-Goes	TELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2022

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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Control Number 21-AS-20211231101126

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: ANTON POINTE, THE	FACILITY NUMBER: 216803982
	VISIT DATE: 03/25/2022

NARRATIVE

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Complainant contacted Department to shared concerns regarding facility wanting resident to move. Family member stated that resident R1 would like to move, but family is very happy with placement and facility services. Based on interviews and documentation review, Department is not able to prove or disprove that resident R1 might have received a verbal unlawful eviction notice.

A finding that the complaint allegations of "Unlawful eviction.” is unsubstantiated meaning that although the allegation 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.

No deficiencies cited during this inspection.

SUPERVISOR'S NAME: Bethany Moellers	TELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Carla Fernandes-Goes	TELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2022

LIC9099 (FAS) - (06/04)

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