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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 315001992
Report Date: 10/07/2021
Date Signed: 10/08/2021 08:57:26 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/30/2021 and conducted by Evaluator Todd Tryon
PUBLIC
COMPLAINT CONTROL NUMBER: 25-AS-20210930133241
FACILITY NAME:GOLD RIVER HOME CAREFACILITY NUMBER:
315001992
ADMINISTRATOR:KURTZ, DIANAFACILITY TYPE:
740
ADDRESS:2235 NAVAS LANETELEPHONE:
(916) 663-1322
CITY:NEWCASTLESTATE: CAZIP CODE:
95658
CAPACITY:6CENSUS: 0DATE:
10/07/2021
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Diana KurtzTIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee not answering the door during visit.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/7/2021 LPA Tryon called licensee Diana Kurtz to do a pre-screening before visiting the facility to open the complaint. She said that no one is living at the home right now, but she agreed to meet me at the house.There are no clients living at the facility, and she is meeting with a real estate agent to put the house on the market. Obviously there is no active COVID at the facility, as no one is living there. LPA had screened myself this morning by taking my temperature and reviewing possible symptoms. :LPA used hand sanitizer before the visit and wore a surgical mask.

When LPA arrived, we toured the house. There appears to be no one there at this time. Since no residents live there, there are no plans to continue running the facility, and there are no staff there because of this, the home cannot be expected to have someone answer the door of an empty house, or answer the phone at the empty house. Therefore, LPA finds the complaint to be unfounded. A finding of unfounded means that the allegation is not true, could not have happened, and/or is without a reasonable basis.
Exit interview conducted.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd TryonTELEPHONE: (916) 208-7709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
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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