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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 425801165
Report Date: 06/06/2022
Date Signed: 06/06/2022 05:41:58 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/18/2022 and conducted by Evaluator Jeannette Olson
COMPLAINT CONTROL NUMBER: 29-AS-20220118091946
FACILITY NAME:BAUER RESIDENTIAL SANTA MARIA IFACILITY NUMBER:
425801165
ADMINISTRATOR:CLINTON CADLEFACILITY TYPE:
735
ADDRESS:943 SUNRISE DRIVETELEPHONE:
(805) 934-1089
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY:4CENSUS: 4DATE:
06/06/2022
UNANNOUNCEDTIME BEGAN:
05:15 PM
MET WITH:Clinton Cadle, AdministratorTIME COMPLETED:
05:45 PM
ALLEGATION(S):
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Facility is not following the proper protocol for COVID-19
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Olson conducted subsequent visit to deliver final findings. LPA met with Clinton Cadle over the phone and staff Robert Dominguez and explained the purpose of the visit.
On 1/20/22 at 10:05 a.m., Licensing Program Analyst (LPA) Toan Luong arrived unannounced for an initial complaint inspection for the above allegation. LPA met with Administrator Clinton Cadle at 10:58 a.m. and explained the reason for the visit. LPA toured the facility and conducted interviews with staff.
Allegation: Facility is not following proper protocol for COVID-19. LPA Luong observed a trash bag hanging on the doorknob inside each of the clients’ rooms during initial complaint inspection. The trash bag did not have a lid. LPA also observed droplet precaution sign was not on the door of a client who tested positive for Covid-19. The sign was posted on the wall across from the door. The facility followed all other protocols. LPA was screened at the entrance, staff were wearing full Personal Protective Equipment, signs were posted throughout the facility to promote good hygiene and social distancing. Bathrooms had soap, paper towels, and additional hand washing signs.
Continued on 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Jeannette Olson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2022
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 29-AS-20220118091946
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: BAUER RESIDENTIAL SANTA MARIA I
FACILITY NUMBER: 425801165
VISIT DATE: 06/06/2022
NARRATIVE
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LPA Luong observed the facility not having a trash bin with a lid inside the clients’ rooms. The allegation Facility is not following proper protocol for COVID-19 did occur and is substantiated. An Advisory Note Technical Assistance is issued.
Exit interview, report emailed, Technical Assistance issued, appeal rights emailed to Administrator.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Jeannette Olson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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