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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486804262
Report Date: 06/30/2026
Date Signed: 06/30/2026 11:08:06 AM

Substantiated


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
05/29/2026 and conducted by Evaluator Elias Magdaleno
COMPLAINT CONTROL NUMBER: 21-AS-20260529082903
FACILITY NAME:YB RESIDENTIAL FACILITYFACILITY NUMBER:
486804262
ADMINISTRATOR:YOUNGBLOOD, RACHELLEFACILITY TYPE:
735
ADDRESS:315 FLAGSTONE CIRCLETELEPHONE:
(707) 673-2108
CITY:SUISUN CITYSTATE: CAZIP CODE:
94585
CAPACITY:3CENSUS: 2DATE:
06/30/2026
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Gasmyne Armstrong, Direct Support ProfessionalTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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Staff does not treat residents with dignity and respect
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Magdaleno arrived unannounced to initiate a 10-day complaint investigation regarding the above allegations and met with Direct Support Professional (DSP), Gasmyne Armstrong. Administrator Rachelle Youngblood was contacted via phone and gave permission for DSP to sign and receive report.

Staff does not treat residents with dignity and respect – Reporting Party (RP) alleges that staff are speaking to clients in a rude manner and are not allowing clients privacy such as entering into their rooms without permission. During the course of this investigation, LPA conducted interviews, made observations, and reviewed records. Interviews with staff indicated that clients have brought items into their rooms that are against facility policies, have refused to clean their rooms, and will refuse staff from entering their rooms to clean them. Interviews with clients indicated there are house policies against having items such as plastic water bottles, food, and other personal appliances in their rooms.
Continued LIC9099C...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Elias Magdaleno
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2026
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 4
Control Number 21-AS-20260529082903
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: YB RESIDENTIAL FACILITY
FACILITY NUMBER: 486804262
VISIT DATE: 06/30/2026
NARRATIVE
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Continued from LIC9099...

Interview with client (C1) indicated that staff have entered their room against their wishes and taken their personal belongs out of their room. Further interview with C1 indicated that staff have also entered other clients rooms without permission while clients are not present. Review of Tenant/Landlord Rights and Responsibilities signed by clients and Administrator indicated that clients “Have a right to privacy. This means that no one can enter my room unless I allow them to enter to enter…”. Review of Personal Rights in Adult Community Care Facilities indicated that clients have “Have a right… to have privacy…” as well as “A right… to possess and use your own personal items…”. Review of facility House Values did not indicate that clients are unable to have items such as plastic water bottles, food, or other personal appliances in their rooms. Further interviews with management indicate House Policies around these items are not written down and are verbally expressed upon client move in. Review of client chart notes indicated that staff entered clients room to clean without informing client or getting client permission beforehand. Review of exchange between client and staff indicated that client was told staff would enter their room without permission unless client cleaned their room. Based upon evidence gathered, there is a preponderance of evidence to prove that the allegation has been SUBSTANTIATED and is valid.

Deficiencies are cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, or repeat violations within a 12-month period, may result in a civil penalty assessment. Appeal rights were provided. See LIC9099D.


Exit interview conducted with Direct Support Professional, whose signature on form confirms receipt.

SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Elias Magdaleno
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 21-AS-20260529082903
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: YB RESIDENTIAL FACILITY
FACILITY NUMBER: 486804262
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/30/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/13/2026
Section Cited
CCR
80072(a)(1)
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80072 Personal Rights
(a)... each client shall have personal rights which include, but are not limited to, the following: (1)To be accorded dignity in his/her personal relationships with staff and other persons.
This requirement not met by licensee as evidenced by:
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Licensee shall notify LPA of training date for all staff on HCBS by Plan of Correction due date of 7/13/2026 by 5:00PM.
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Document review and interviews indicated that staff entered client room without client permission as well as threatened to continue entering without permission which poses/posed a potential personal rights risk to persons in care.
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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: Victoria Bertozzi
LICENSING EVALUATOR NAME: Elias Magdaleno
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
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
05/29/2026 and conducted by Evaluator Elias Magdaleno
COMPLAINT CONTROL NUMBER: 21-AS-20260529082903

FACILITY NAME:YB RESIDENTIAL FACILITYFACILITY NUMBER:
486804262
ADMINISTRATOR:YOUNGBLOOD, RACHELLEFACILITY TYPE:
735
ADDRESS:315 FLAGSTONE CIRCLETELEPHONE:
(707) 673-2108
CITY:SUISUN CITYSTATE: CAZIP CODE:
94585
CAPACITY:3CENSUS: 2DATE:
06/30/2026
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Gasmyne Armstrong, Direct Support ProfessionalTIME COMPLETED:
11:20 AM
ALLEGATION(S):
1
2
3
4
5
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7
8
9
Staff handled resident in a rough manor
INVESTIGATION FINDINGS:
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12
13
Licensing Program Analyst (LPA) Magdaleno arrived unannounced to initiate a 10-day complaint investigation regarding the above allegations and met with Direct Support Professional (DSP), Gasmyne Armstrong. Administrator Rachelle Youngblood was contacted via phone and gave permission for DSP to sign and receive report.
Staff handled resident in a rough manor – Reporting Party (RP) alleges that facility staff used force to handle client (C1) in care during an incident at the facility. Interviews with two (2) of two (2) staff present during the incident indicated that the C1 was redirected by staff without using physical force. Interviews with one (1) of two (2) clients present during the incident indicated that staff and client were involved in a verbal disagreement before staff redirected C1 into another area of the facility without force or roughness. Interview with C1 indicated that they were moved against their wishes. 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.
No deficiencies cited. Exit interview conducted with Direct Support Professional, whose signature on form confirms receipt.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Elias Magdaleno
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4