<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 286803573
Report Date: 09/29/2025
Date Signed: 10/21/2025 12:13:40 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
06/18/2025 and conducted by Evaluator Julie Florio
COMPLAINT CONTROL NUMBER: 21-AS-20250618153003
FACILITY NAME:E.R.SALGADO,INC./SAINT LUCIA RESIDENTIAL CAREFACILITY NUMBER:
286803573
ADMINISTRATOR:ROSE SALGADOFACILITY TYPE:
735
ADDRESS:134 LANDANA STREETTELEPHONE:
(707) 315-4838
CITY:AMERICAN CANYONSTATE: CAZIP CODE:
94503
CAPACITY:6CENSUS: 6DATE:
09/29/2025
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Rose Salgado, LicenseeTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is not staffed appropriately.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
***AMENDED***

On 10/21/2025, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to amend complaint investigation findings originally delivered to Licensee on 09/29/2025 and issues an immediate civil penalty in the amount of $500.00 as indicated per regulation.

On 09/29/2025, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to deliver complaint #21-AS-20250618153003 investigation findings regarding the above allegation and met with Rose Salgado, Licensee. Reporting Party (RP) alleges that the facility is not staffed appropriately.

LPA Florio conducted 10-day complaint investigation visit on 06/19/2025 and obtained documents, made observations, and conducted interviews.
Continued on LIC9099C...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Julie Florio
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 21-AS-20250618153003
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: E.R.SALGADO,INC./SAINT LUCIA RESIDENTIAL CARE
FACILITY NUMBER: 286803573
VISIT DATE: 09/29/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
***AMENDED*** Continued from LIC9099...

During this visit, LPA obtained a LIC500 Personnel Record which indicates that Staff 3 (S3) works Sunday at 7:00 AM through Thursday at 9:00 PM; Staff 4 (S4) works Friday 7:00 AM through Sunday at 9:00 PM; and Licensee and Staff 5 (S5) work varying hours as needed. On Monday, 09/29/2025, LPA observed S3 leave the facility at approximately 11:30 AM; Licensee left the facility at approximately 11:30 AM to obtain paperwork; and S4 did not arrive at the facility until approximately 12:10 PM, leaving three clients and no staff present in the facility during this time.

On 06/19/25 and 09/29/2025, all four client interviews conducted revealed that clients are left unsupervised for brief periods of time when change of shift occurs and when a staff needs to leave early or arrive late. These interviews also revealed that clients are sometimes asked to "keep an eye" on another client while staff are away. On 06/19/2025, LPA obtained a copy of each client's LIC602 Physician's Report which indicates that each client is able to leave the facility unassisted. LPA explained to licensee that this means that they are able to be out in the community unsupervised but does change the regulatory requirement that a staff person shall be present in the facility at all times. Additionally, LPA explained that per regulation "[c]lients shall not be used as substitutes for required staff." Licensee conveyed understanding and agrees to operate in compliance with this regulation at all times.

Based on observations made, interviews conducted and records obtained, the allegation that the facility is not staffed appropriately is SUBSTANTIATED. A finding that a complaint allegation is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met.

Deficiency is cited from Title 22 Regulations, Division 6, (see LIC9099D).

***An Immediate Civil Penalty in the total amount of $500 is being assessed for the observed clients being left at the facility without staff present, which is a violation of personnel requirements and an immediate health, safety, and/or personal rights violation to persons in care, (see LIC421IM).***

Exit interview conducted with Licensee, whose signature on form confirms receipt of documents. Copy of report and appeal rights provided to Licensee.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Julie Florio
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 21-AS-20250618153003
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: E.R.SALGADO,INC./SAINT LUCIA RESIDENTIAL CARE
FACILITY NUMBER: 286803573
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/29/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/31/2025
Section Cited
CCR
80065(k)
1
2
3
4
5
6
7
Personnel Requirements 80065(k) When regular staff members are absent, there shall be coverage by personnel capable of performing assigned tasks….
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee agrees to submit an updated LIC500 Personnel Report which accurately reflects personnel schedules to ensure the facility is appropriately staffed at all times to CCLD by POC due date of 10/31/2025.
8
9
10
11
12
13
14
Based on observations made, records reviewed, and interviews conducted, Licensee did not ensure the facility was staffed appropriately. This poses a potential Health, Safety and/or Personal Rights risk to residents in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Julie Florio
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3