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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700814
Report Date: 04/29/2022
Date Signed: 04/29/2022 11:51:55 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/08/2022 and conducted by Evaluator Maja Jensen
COMPLAINT CONTROL NUMBER: 27-AS-20220408141202
FACILITY NAME:A LOVING PLACE FOR YOUR PARENTSFACILITY NUMBER:
392700814
ADMINISTRATOR:DENISE ORDONEZFACILITY TYPE:
740
ADDRESS:488 POELSTRA COURTTELEPHONE:
(714) 948-0381
CITY:RIPONSTATE: CAZIP CODE:
95366
CAPACITY:6CENSUS: DATE:
04/29/2022
UNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:TIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff/Admin using their own money to buy food
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Maja Jensen and Licensing Program Manager (LPM) Liza King conducted an unannounced facility visit to complete and deliver a finding for a complaint investigation received on 04/08/2022. LPA Jensen and LPM King met with Licensee Nataley Martinez and discussed the conclusion of the complaint and the finding.

The initial 10-day visit was conducted on 04/09/2022. LPA Jensen interviewed the Licensee, the Administrator, a caretaker staff member and residents of the facility. Staff did on occasion bring food into the facility which was consumed by the guests however there is insufficient evidence to determine the motivation for these actions.
It was determined in the course of the investigation based on the information provided through interviews, the aforementioned allegation is UNSUBSTANTIATED.

A finding that the allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Maja JensenTELEPHONE: 916-639-5584
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2022
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 27-AS-20220408141202
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: A LOVING PLACE FOR YOUR PARENTS
FACILITY NUMBER: 392700814
VISIT DATE: 04/29/2022
NARRATIVE
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Per the California Code of Regulations, Title 22, Division 6, no deficiencies observed or cited. An exit interview was held with Licensee Nataley Martinez and copy of this report given to Licensee Nataley Martinez.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Maja JensenTELEPHONE: 916-639-5584
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2