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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 286804053
Report Date: 01/09/2025
Date Signed: 01/09/2025 10:38:19 AM

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
10/25/2024 and conducted by Evaluator Christopher Arnhold
COMPLAINT CONTROL NUMBER: 21-AS-20241025143410
FACILITY NAME:NAZARETH ROSE GARDEN OF NAPAFACILITY NUMBER:
286804053
ADMINISTRATOR:RAGLAND, SHANTIFACILITY TYPE:
740
ADDRESS:903 SARATOGA DRIVETELEPHONE:
(707) 252-7488
CITY:NAPASTATE: CAZIP CODE:
94559
CAPACITY:44CENSUS: 27DATE:
01/09/2025
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Shanti RaglandTIME COMPLETED:
10:45 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff has not addressed scabies outbreak in facility
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
At approximately 08:45AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to conduct an investigation into the above allegation. LPA met with Administrator Shanti Subba, reviewed records and toured the facility. LPA received copies of documents. Based on records reviewed and interviews conducted, resident (R1) was admitted to the facility 07/17/2024, and was given a head to toe examination. This exam revealed some redness on the front of the body. Resident did not display any discomfort until September 30th. Facility notified the physician and requested treatment. Facility continued to document and monitor and was in communication with the physician. An appointment was scheduled with a physician for another examination but due to resident behaviors, the appointment did not help. Facility continued to communicate with physician to address the skin condition. Home Health was ordered to evaluate resident, but do to insurance issues, the home health visit did not occur. Facility continued to communicate with the physician on a course of treatment. Based on records reviewed, there have been no tests done to diagnose the skin condition to confirm scabies. There are no diagnosed cases of scabies in the building.
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:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025
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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