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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486803953
Report Date: 07/11/2023
Date Signed: 07/27/2023 12:06:59 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, 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
04/07/2023 and conducted by Evaluator Karina Canela
PUBLIC
COMPLAINT CONTROL NUMBER: 21-AS-20230407164133
FACILITY NAME:HIGH POINTE RESIDENCESFACILITY NUMBER:
486803953
ADMINISTRATOR:WARD, DANTEFACILITY TYPE:
735
ADDRESS:1737 YORK ST.TELEPHONE:
(707) 712-8038
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY:4CENSUS: 4DATE:
07/11/2023
UNANNOUNCEDTIME BEGAN:
03:50 PM
MET WITH:Dante Ward, Licensee & AdministratorTIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff conduct poses a risk to residents in care.

Unqualified individuals providing care and supervision to residents.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
**This report is an amended revision from original complaint report dated 7/11/2023*. LPA Tobola is conducting visit to acquire sigantures regarding amended report. LPA Tobola met with Lead DSP, Marcel Love and Administrator, Dante Ward was contacted and notified of visit.**
Licensing Program Analyst (LPA) Karina Canela arrived unannounced at High Pointe Residences to deliver complaint findings. LPA met with Dante Ward, Licensee and Administrator.

LPA investigated the above allegations. During the investigation LPA requested copies of documents from the Licensee and Administrator. Interviews were conducted with relevant parties and observations were made.


Report continued on LIC9099-C ...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023
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 4
Control Number 21-AS-20230407164133
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: HIGH POINTE RESIDENCES
FACILITY NUMBER: 486803953
VISIT DATE: 07/11/2023
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
Page 2 of 4

The following was reported to The State of California Department of Social Services (DSS), Community Care Licensing Division (CCLD), Santa Rosa Regional Office:

It appears the staff was possibly inebriated on the job and providing drugs to a residents/client(s). It was reported an individual (I1) working at the facility was smoking marijuana on the facility premises around/near clients. It was reported S1 left their marijuana vape pen unsupervised in the facility and accessible to clients. It was reported Client (C1) used I1’s marijuana vape pen which was left accessible in the facility. Additionally, it was reported an individual (I2) working at the facility consistently sells or provides marijuana to clients.

Complaint findings regarding “Unqualified individuals providing care and supervision to residents”


Based on record review and Administrator’s statement, Individual (I1) was working and providing care to clients since approximately January 2023. I1 was non-associated and not fingerprint cleared at the time; I1 became associated on 03/30/2023. I1 was observed working on 03/07/2023. Interviews conducted indicated I1 continued working until they were associated to the facility. Interviews conducted confirmed Individual (I1) does smoke marijuana on the facility premises, outside during their break, but while on shift.
Additionally, Interviews revealed Individual (I2) lives across the street and works at the facility. I2 has provided services to clients such as supervision, medication administration, and maintenance of the facility. Administrator denied the allegations and stated the individual who lives across the street has a different name. Administrator stated individual (I2) has been allowed to enter the facility to provide maintenance such as repairs. Administrator stated I2 provided marijuana to Client (C1) on one occasion when C1 was upset/angry and pacing in the front yard. Administrator stated they instructed clients to no longer have contact with neighbor I2. Interviews conducted revealed the neighbor I2 had been working at the facility under their legal name and providing services to clients. As of today, 07/11/2023, I2 is not fingerprint cleared, is not associated to the facility, and is not eligible for a clearance (would require an exemption). Interviews confirmed I2 has provided marijuana to clients at High Pointe Residences.
Report continued on LIC9099-C
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 21-AS-20230407164133
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: HIGH POINTE RESIDENCES
FACILITY NUMBER: 486803953
VISIT DATE: 07/11/2023
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
Page 3 of 4
Complaint findings for “Staff conduct poses a risk to residents in care”
Interviews conducted with Administrator Dante Ward revealed they knowingly allowed non-associated or non-fingerprinted cleared individuals (I1 and I2) to work in the facility and provide care to clients such as medication administration, supervision, and maintenance to the facility. Interviews with Administrator confirmed I2 has provided marijuana to client (C1). Additional interviews with relevant parties confirmed I2 has provided marijuana to other clients in the facility on several occasions. Additionally, I1 & I2 do not have record of completing initial training such as medication training on file. Interviews revealed I2 was administering medication to clients.

This agency has investigated the complaint alleging "Unqualified individuals providing care and supervision to residents” and "Staff conduct poses a risk to residents in care".
Based on record review and interviews conducted, Administrator knowingly allowed individuals I1, I2 & I3, who were not associated and not fingerprint cleared, to work at High Pointe Residences providing care, supervision and providing marijuana to clients during complaint inspection. I2 is not eligible for a fingerprint clearance at this time. The preponderance of evidence standard has been met; therefore the above allegations are both found to be SUBSTANTIATED. California Code of Regulations and Health & Safety Code, (Title 22, Division 6 & Chapter 8), is being cited on the attached LIC 9099D. Appeal rights provided.

A civil penalty was assessed in the total amount of $800 for individuals (I1, I2, I3) who were working at the facility without a valid fingerprint clearance. I2 is not eligible for a fingerprint clearance and requires an approved exemption.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 21-AS-20230407164133
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: HIGH POINTE RESIDENCES
FACILITY NUMBER: 486803953
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/11/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/12/2023
Section Cited
CCR
80019(e)(1)
1
2
3
4
5
6
7
80019 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department
1
2
3
4
5
6
7
Licensee to submit a written plan of how they will meet the regulation. Written plan to include Licensee statement that they understand the regulation and will be in future compliance & I2 cannot work or be present in the facility until cleared and associated. POC to be submitted to Community Care Licensing (CCL) by POC due date 07/12/2023
8
9
10
11
12
13
14
This requirement was not met as evidenced by: Based on record review and interviews, Licensee did not ensure the above regulation due to allowing Individuals (I1, I2, I3) to provide services to clients while I1,I2,I3 were not fingerprint cleared or associated to the facility. This is an immediate safety and personal rights risk to clients in care.
8
9
10
11
12
13
14
A Civil Penalty was assessed in the amount of $800 for non-fingerprint cleared Individuals (I1, I 2, I3) working
Type A
07/12/2023
Section Cited
CCR
80072(a)(2)
1
2
3
4
5
6
7
80072 Personal Rights (a)...each client shall have personal rights which include, but are not limited to, the following: (2) To be accorded safe, healthful and comfortable accommodations... to meet his/her needs.This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Licensee to submit a written plan of how they will ensure the regulation 80072(a)(2), that clients are accorded safe, healthful and comfortable accomodations to meet client's needs. Statement to be submitted to CCL by POC due dat 07/12/2023
8
9
10
11
12
13
14
Based on record review and interviews, Licensee did not ensure the above regulation due to allowing Individuals (I1, I2) to provide services to clients while I1,I2 were not fingerprint cleared. I1 & I2 left marijuana accessible to clients. This is an immediate health, safety and personal rights risk to clients in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Hope DeBenedetti
LICENSING EVALUATOR NAME: Karina Canela
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4