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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486804059
Report Date: 12/06/2024
Date Signed: 12/06/2024 11:36:58 AM

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
09/18/2024 and conducted by Evaluator Julie Florio
COMPLAINT CONTROL NUMBER: 21-AS-20240918103321
FACILITY NAME:ARVEAH'S CARE HOMES 3FACILITY NUMBER:
486804059
ADMINISTRATOR:MARTINEZ-DAVIS, LEAHFACILITY TYPE:
740
ADDRESS:2033 MARSHALL ROADTELEPHONE:
(530) 662-6055
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY:6CENSUS: 3DATE:
12/06/2024
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:John Piolo Danting, Designated Responsible PartyTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Staff sexually abused resident in care.
Uncleared staff caring and supervising resident in care.
INVESTIGATION FINDINGS:
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On 12/6/2024, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to deliver findings for a complaint the Department investigated related to the allegations of “staff sexually abused resident in care” and “uncleared staff caring and supervising resident in care”. Based on a review or records and interviews with staff, resident, and outside parties the allegations are UNSUBSTANTIATED.

During the investigation the Department learned resident listed as R1 refused peri-care from a caregiver and indicated there was injury to their groin area. Caregiver did not observe injury and contacted the licensee who arrived timely to assess. R1 allowed licensee to provide peri-care and observe for injury, no injury was observed. Reporting Party indicated staff listed as S4 and S5 suspected staff listed as S3 to have possibly abused R1. There was no evidence to corroborate this allegation. Vacaville PD report was obtained and reviewed.

Continued on LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Julie Florio
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024
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-20240918103321
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: ARVEAH'S CARE HOMES 3
FACILITY NUMBER: 486804059
VISIT DATE: 12/06/2024
NARRATIVE
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Staff listed as S3, S4 and S5 were fingerprint cleared and associated to work at facility. Personnel records were observed to be current and on file for these individuals during a Case Management visit conducted on July 9, 2024. These individuals are no longer employed at facility, S3 left in July of 2024 and S4 and S5 left in August of 2024.

Complaint findings delivered today, no citations issued.

Exit interview conducted with Designated Responsible Party, whose signature on form confirms receipt of documents.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Julie Florio
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2