<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 480102381
Report Date: 05/22/2025
Date Signed: 05/22/2025 02:41:55 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/03/2025 and conducted by Evaluator Elias Magdaleno
COMPLAINT CONTROL NUMBER: 21-AS-20250403132421
FACILITY NAME:JO-MIL GROUP HOMEFACILITY NUMBER:
480102381
ADMINISTRATOR:CHERYL DAVIDSONFACILITY TYPE:
735
ADDRESS:143 RUTGERSTELEPHONE:
(707) 553-1581
CITY:VALLEJOSTATE: CAZIP CODE:
94589
CAPACITY:6CENSUS: 4DATE:
05/22/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Caregiver Shane Mills, Administrator Cheryl DavidsonTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff touched client innappropriately
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
At approximately 2:00 PM Licensing Program Analyst (LPA) Magdaleno arrived unannounced to conduct a complaint investigation and deliver findings regarding the above allegations and met with Shane Mills, Caregiver. Cheryl Davidson, Administrator, attended via phone call and designated Caregiver to sign report.
The Department received an allegation that facility staff touched client inappropriately. The Reporting Party stated that on Wednesday, 04/02/2025, client (C1) began engaging in conversation with others about ways of relaxing, C1 then began explaining how staff (S1) at their residency relaxes them daily when they wake them up in the morning by giving them a full body massage with their “magical hands”. Per Reporting Party, they then asked C1 for an example of what they meant by “full body massage”. C1 demonstrated with their hands how S1 would massage them. Also, while demonstrating, C1 stated that “S1 is sweet on me” while rubbing their upper body inappropriately. While disclosing this information, C1 stated “I shouldn’t have said that it slipped out”.
Continue on LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Elias Magdaleno
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025
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 21-AS-20250403132421
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: JO-MIL GROUP HOME
FACILITY NUMBER: 480102381
VISIT DATE: 05/22/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Continued from LIC9099…

On 4/08/25, LPA conducted 10-day visit to the facility made observations, reviewed records, and conducted interviews with staff. During records review, C1’s care plan dated 6/25/24 indicates that C1 feels like staff treats them with respect and they feel safe at home. Also, review of C1 physician’s report did not provide any supporting information that could lead to any evidence of behaviors of a history of false accusations. The incident was cross reported to Vallejo Police Department, but LPA was informed that there were no calls for service/reports of any incidents within the time frame when incident was reported at this address and C1's information yielded no calls for service/reports with that agency. On 5/20/25, LPA corroborated agency was cross reported as well. LPA conducted interviews with staff (S1 & S2) and clients (C1, C2 & C3) in care, which revealed contradictory information regarding the situation and LPA is unable to determine if relaxing techniques resulted in the allegation that staff touched C1 inappropriately. Based on interviews conducted and records obtained, the investigation revealed that, although informed of the incident that was reported, the Department did not obtain supporting information to prove or disprove the allegation of facility staff touched client inappropriately. However, LPA had a discussion with the Administrator emphasizing the needs of implementing a plan to ensure the safety and respect of the client’s dignity in their personal relationships with staff. A finding that the complaint allegation that facility staff touched client inappropriately is unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Elias Magdaleno
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2