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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486804052
Report Date: 07/24/2025
Date Signed: 07/24/2025 01:13:09 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
05/29/2025 and conducted by Evaluator Christi Coppo
COMPLAINT CONTROL NUMBER: 21-AS-20250529142516

FACILITY NAME:C & R CARE HOME LLCFACILITY NUMBER:
486804052
ADMINISTRATOR:BAYOT, ROBERT CHRISTIANFACILITY TYPE:
740
ADDRESS:373 HERON WAYTELEPHONE:
(510) 789-5155
CITY:VACAVILLESTATE: CAZIP CODE:
95688
CAPACITY:5CENSUS: DATE:
07/24/2025
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:CaregiverTIME COMPLETED:
01:27 PM
ALLEGATION(S):
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Staff sleeping in common area during working hours
Due to lack of supervision, resident eloped
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Christi Coppo and Ethel Contreras arrived at this facility unannounced, to deliver findings into the above allegations. Adminstrator reached by phone. Caregiver signed report

Complaint alleges staff sleeping in common area during working hours. Complainant states staff observed sleeping on the couch during the day shift while supposed to be working. During investigation, LPA conducted interviews. LPA did not receive any reports or observations of staff sleeping while on duty. LPA unable to confirm staff sleeping on couch while on duty. So, 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.

Complaint alleges due to lack of supervision, resident eloped. Complainant states that on 5/28/25

continued to 9099AC...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Christi Coppo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 21-AS-20250529142516
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: C & R CARE HOME LLC
FACILITY NUMBER: 486804052
VISIT DATE: 07/24/2025
NARRATIVE
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continued from 9099A...

resident (R1) was allowed to elope. CCL defines elopement as having to meet 2 criteria: being outside of he facility and being unattended. During investigation, LPA reviewed R1’s physician report indicating R1 was ambulatory and had diagnosis of dementia. During investigation, LPA reviewed evidence indicating R1 had been outside in front of the facility for an extended period of time and that facility staff was having difficulty getting R1 to come back inside facility. Facility admits that R1 was often outside for extended periods of time. However, facility claims that a staff member always had watch over R1; so, R1 was never left unsupervised, despite R1’s refusals to come back inside the facility. Facility claims that R1 was never outside alone or unsupervised. So, due to conflicting accounts regarding the supervision of R1 while outside, and 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.

Exit interview conducted with caregiver and a copy of this report given.
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Christi Coppo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 6