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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 425801343
Report Date: 10/06/2022
Date Signed: 10/06/2022 12:17:58 PM

Unsubstantiated


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
08/31/2022 and conducted by Evaluator Rachael De Leon
COMPLAINT CONTROL NUMBER: 29-AS-20220831090210
FACILITY NAME:BAUER RESIDENTIAL-SANTA MARIA IIFACILITY NUMBER:
425801343
ADMINISTRATOR:CLINTON CADLEFACILITY TYPE:
735
ADDRESS:3842 MIRA LOMA DRIVETELEPHONE:
(805) 938-9196
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY:4CENSUS: 4DATE:
10/06/2022
UNANNOUNCEDTIME BEGAN:
10:08 AM
MET WITH:Clinton Cadle, AdministratorTIME COMPLETED:
10:32 AM
ALLEGATION(S):
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Facility staff did not adequately supervise residents while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) De Leon conducted a subsequent complaint visit to the facility above to deliver final findings in the complaint investigation. LPA met with Administrator Clinton Cadle and explained the purpose of the visit.

LPA De Leon conducted the initial 10-day visit and collected records on 09/06/2022 from 10:20 AM-11:15 am. LPA interviewed staff on 09/06/2022 at 10:30 am and at 10:50 am. LPA interviewed additional staff on 09/26/2022 at 9:55 AM. LPA spoke with Tri-Counties Regional Center (TCRC) Quality Assurance (QA) on 08/31/2022 and again on 09/26/2022 at 12:35 pm.

On the allegation: Facility staff did not adequately supervise residents while in care. LPA De Leon conducted interviews with staff that revealed staff 3 (S3) and staff 2 (S2) took 4
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022
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-20220831090210
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 II
FACILITY NUMBER: 425801343
VISIT DATE: 10/06/2022
NARRATIVE
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residents (R1)(R2)(R3)(R4) on an outing into the community on 08/30/2022 around 12:00pm. S3 drove the facility van and stopped to run an errand at a store around 12:30 pm. S3 and Resident 3 (R3) vacated the van and went into the store. Resident R1, R2, R4 stayed in the van with S2. R1 and R2 were seated in the middle seat of the van while S2 and R4 were in the back seat. S2 had the keys in the van, water was available to drink, all windows were unrolled and S2, R1, R2, R4 waited around 15 minutes for S3/R4 to return to the vehicle. The van back seat window was tinted, and the middle seat had sunshades in the windows. S2 said no one was in distress at any time and a staff was always present with the residents in care. TCRC QA investigated the allegation and closed the case as Inconclusive. Based on lack of evidence the allegation is deemed Unsubstantiated at this time.


Exit interview conducted, copy of report emailed to the Administrator.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2