286803790-5-12-2023-21-AS-HDBI-CSDRB7-20230601125212

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 286803790
Report Date: 05/12/2023
Date Signed: 05/12/2023 12:34:31 PM

Unfounded

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
04/04/2023 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20230404110226

FACILITY NAME:	ROSE HAVEN LLC		FACILITY NUMBER:	286803790
ADMINISTRATOR:	FRANCO, RHON		FACILITY TYPE:	740
ADDRESS:	520 SANITARIUM RD		TELEPHONE:	(707) 963-3748
CITY:	ST HELENA	STATE: CA	ZIP CODE:	94574
CAPACITY:	32	CENSUS: 10	DATE:	05/12/2023
		UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Rhon Franco		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Licensee did not provide resident with a refund

INVESTIGATION FINDINGS:

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At approximately 11:45AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to deliver findings from an investigation into the above allegation. LPA met with Administratror Rhon Franco and reviewed records. Based on records reviewed, the resident admission agreement states a 30 day notice is to be provided to the facility from the resident to terminate the agreement. Resident moved from the facility after 17 days and did not provide an advance 30 day notice. The facility did not charge any administrative fees, therefore there is no requirement a refund be issued. LPA received copies of documents.

This agency has investigated the above allegation. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Bethany Moellers	TELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Christopher Arnhold	TELEPHONE: (707) 588-5084
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023

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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