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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347003654
Report Date: 06/21/2023
Date Signed: 06/21/2023 03:28:14 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
06/05/2023 and conducted by Evaluator Kevin Mknelly
COMPLAINT CONTROL NUMBER: 59-AS-20230605094020
FACILITY NAME:SUTTER HOUSEFACILITY NUMBER:
347003654
ADMINISTRATOR:SHERYL C ZONIOFACILITY TYPE:
735
ADDRESS:5721 SUTTER AVETELEPHONE:
(916) 972-8497
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:6CENSUS: 6DATE:
06/21/2023
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:CaregiverTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Facility grounds are in disrepair.
Facility staff are not addressing the presence of rats on the facility grounds.
Facility staff are not providing adequate care and supervision to the residents.
INVESTIGATION FINDINGS:
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On 6/21/23, Licensing Program Analyst (LPA) Kevin Mknelly conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with a caregiver/ designee. LPA spoke with the Administrator by phone.

LPA conducted records review, inspections and extensive interviews.
LPA is unable to find and or meet the preponderance, per policy.
Inspections found the buildings and grounds to be maintained as required during the time of this investigation. The home is observed to be clean and free of hazards.
While caregivers have also witnessed vermin on the property occasionally, none have been present within the property building or outbuilding. LPA inspected storage sheds on the property. Inspections and interviews found no evidence of vermin having inhabited the sheds.
The property owner conducts routine and as needed pest control.
Only one of the current 6 clients moves in the community unassisted. That client is often provided transportation. When walking independently, the client, in interviews stated understanding of safety and
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2023
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 2
Control Number 59-AS-20230605094020
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: SUTTER HOUSE
FACILITY NUMBER: 347003654
VISIT DATE: 06/21/2023
NARRATIVE
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respect for property. Other clients were observed to be provided care and supervision for their identified needs.

As a result of this investigation, LPA finds allegation to be (US)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 the evidence to prove that the alleged violation occurred.

Exit interview with administrator.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2