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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 275294305
Report Date: 08/12/2025
Date Signed: 08/15/2025 02:25:55 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO ASC, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/05/2025 and conducted by Evaluator Sarah Hurt
COMPLAINT CONTROL NUMBER: 24-AS-20250805080503
FACILITY NAME:GREEN PINES RESIDENTIAL CARE HOMEFACILITY NUMBER:
275294305
ADMINISTRATOR:LUMBI, PAUL N.FACILITY TYPE:
740
ADDRESS:11 SAGUARO CIRCLETELEPHONE:
(831) 424-7336
CITY:SALINASSTATE: CAZIP CODE:
93905
CAPACITY:6CENSUS: 4DATE:
08/12/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Licensee, Paul LumbiTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff refused to accept the resident back to the facility
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 08/12/2025, Licensing Program Analyst (LPA) Sarah Hurt arrived to the facility unannounced to deliver findings on the above allegation. LPA met with Licensee Paul Lumbi via telephone and stated the purpose of the visit.

Regarding the allegation Staff refused to accept the resident back to the facility. Resident 1 is not and has never been a resident of this facility. Based on the information received, we have found that the complaint is Unfounded, meaning that the allegation is false, could not have happened, and/or is without reasonable basis, therefore, we have dismissed the complaint. Exit interview conducted over the phone with Licensee Paul Lumbi. A copy of this report was provided at the time of visit. No deficiencies cited.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Sarah Hurt
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2025
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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