317005123-10-14-2025-59-AS-MSEY-DMGMP8-20251015094641

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 317005123
Report Date: 10/14/2025
Date Signed: 10/14/2025 01:34:04 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/07/2025 and conducted by Evaluator Melissa Parks

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20251007135629

FACILITY NAME:	PAULETTE, PHOEBE & HOWARD'S FAMILY HOME		FACILITY NUMBER:	317005123
ADMINISTRATOR:	HUNTSBERRY, HOWARD		FACILITY TYPE:	735
ADDRESS:	1899 DELOUCH DR		TELEPHONE:	(916) 409-9391
CITY:	LINCOLN	STATE: CA	ZIP CODE:	95648
CAPACITY:	4	CENSUS: 4	DATE:	10/14/2025
		UNANNOUNCED	TIME BEGAN:	12:35 PM
MET WITH:	Howards Huntsberry		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Facility staff transporting residents under the influence of marijuana.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Melissa Parks arrived unannounced on Tuesday October 14, 2025, to conduct a complaint investigation regarding the above allegation. LPA met with Administrator Howard and explained the purpose of the visit.

LPA interviewed staff regarding the allegation. LPA learned that staff was driving R1 to and from their day program until transportation was established. Staff had a habit of smoking black and mild/cigars but never when transporting R1, around the clients, or inside the facility. Staff denied ever using marijuana.

Based on information obtained during the investigation, LPA finds the allegation to be UNSUBSTANTIATED- a finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

Exit interview. A copy of this report was emailed to the Administrator.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Melissa Parks
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2025

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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