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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486803906
Report Date: 07/02/2026
Date Signed: 07/02/2026 02:03:35 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
06/23/2026 and conducted by Evaluator Star Stevenson
COMPLAINT CONTROL NUMBER: 21-AS-20260623164444
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: 4DATE:
07/02/2026
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Keyshawn Melton-Caregiver with Designation of Facility Responsibiltiy. TIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff do not ensure hallways have adequate lighting
INVESTIGATION FINDINGS:
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On 07/02/2026 Licensing Program Analyst (LPA) Star Stevenson arrived unannounced to deliver complaint findings of a complaint received by the Department on 06/23/2026.

LPA met with caregiver Keyshawn Melton who has Designation of Facility Responsibility (RP). A call was recieved from Licensee Anny Camerino and report was read to Licensee with a plan for RP to sign today's report.

The complaint alleges that staff do not ensure hallways have adequate lighting.

LPA made observations, took photographs, obtained documents and conducted interviews with both staff and four (4) residents.


Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Star Stevenson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2026
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-20260623164444
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: 07/02/2026
NARRATIVE
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Continued from LIC9099

LPA observed two long LED light fixtures in each hallway that could contain three (3) bulbs each, but each contained just two (2) bulbs and both light fixtures and their switches were observed to be operational and emitting bright light for each hallway.

In interviews with four (4) of four residents LPA learned that the facility has lighting in both hallways and that residents are free to use the light switch to turn the lights on when in the hallway. LPA also learned that residents are repeatedly asked to turn the hallway light off when not in use.

Additional interviews with two (2) staff members reveal that staff do not shut the hallway lights off on residents while they are using them but do ask residents to shut the hallway light off when not in use and will shut the lights off themselves when they see residents not using the hallway.

Because the facility has operating hallway lights emitting adequate light for night use, and because staff do not turn the lights off on residents while in use, the complaint that staff do not ensure hallways have adequate lighting is unsubstantiated.

A finding that the complaint allegation is Unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

No Deficiencies Cited during visit.

Exit interview conducted with RP

Signature on form confirms receipt.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Star Stevenson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2026
LIC9099 (FAS) - (06/04)
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