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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486803906
Report Date: 05/07/2025
Date Signed: 05/07/2025 01:11:48 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
02/05/2025 and conducted by Evaluator Julie Florio
COMPLAINT CONTROL NUMBER: 21-AS-20250205163033
FACILITY NAME:LUVINHOME,LLCFACILITY NUMBER:
486803906
ADMINISTRATOR:CAMERINO, ANNY K.FACILITY TYPE:
740
ADDRESS:974 SUFFOLK WAYTELEPHONE:
(707) 999-8276
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY:6CENSUS: DATE:
05/07/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Anny K. Camerino, Administrator and Licensee Ceasar CamerinoTIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Personal rights
INVESTIGATION FINDINGS:
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On 05/07/2025, the Department conducted a scheduled in-office meeting with facility where Licensing Program Analyst (LPA) Julie Florio delivered complaint #21-AS-20250205163033 investigation findings regarding the above allegation and met with Anny K. Camerino, Administrator and Licensee Ceasar Camerino. Reporting Party (RP) alleges a personal rights violation regarding the management of Resident 1’s (R1's) personal finances.

LPA conducted 10-day complaint investigation visit at the facility on 02/14/2025 and obtained documents, made observations, and conducted interviews. During the visit, LPA obtained copies of R1’s physician’s report which indicated that R1 is unable to manage their own cash resources and a signed admissions agreement with North Bay Regional Center which states R1 agrees to the appointment of a third party financial advisor to manage their government benefits and finances.

Continued on LIC9099C...

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Julie Florio
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2025
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-20250205163033
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: LUVINHOME,LLC
FACILITY NUMBER: 486803906
VISIT DATE: 05/07/2025
NARRATIVE
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Continued from LIC9099...

Based on record review and interviews conducted, LPA was able to determine that R1 has a known documented history of mismanaging their money and being confused about it.

Based on record review, interviews conducted, and observations made, the allegation that the facility has committed a personal rights violation regarding the management of Resident 1’s (R1s) personal finances is UNSUBSTANTIATED. A finding that the complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies cited.

Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Julie Florio
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2