490107656-5-10-2024-21-AS-VBEI-D68RYH-20240614132618

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 490107656
Report Date: 05/10/2024
Date Signed: 05/10/2024 09:34:01 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
02/02/2024 and conducted by Evaluator Caitlynn Felias

COMPLAINT CONTROL NUMBER: 21-AS-20240202174028

FACILITY NAME:	SPRING LAKE VILLAGE		FACILITY NUMBER:	490107656
ADMINISTRATOR:	PRESSEY, JEANIE		FACILITY TYPE:	741
ADDRESS:	5555 MONTGOMERY DRIVE		TELEPHONE:	(707) 538-8400
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95409
CAPACITY:	679	CENSUS: 35	DATE:	05/10/2024
		UNANNOUNCED	TIME BEGAN:	08:25 AM
MET WITH:	Administrator, Daniel Skillman, and Director of Health Services, Sharon Shnell-Hobbs		TIME COMPLETED:	09:00 AM

ALLEGATION(S):

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Fraudulent Billing

INVESTIGATION FINDINGS:

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Christina Hadley investigated the allegations into possible violations of contuning care statutes. During the course of the investiation it was determined that the facility experienced a glitch in their electronic billing system. This matter has since been addressed and affected residents have either been credited for overcharges, or billed additionally for charges that should have been billed but had not.
Although this glitch caused an inconvenience to some residents, there is no proof that this incident was done with ill intent or malice. As of this date, the Executive Director attests to the fact that the system is working properly and that the community has had no new complaints/concerns from residents about being billed multiple times for services.

A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that alleged abuse occurred.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Victoria Bertozzi	TELEPHONE: (707) 588-5059
LICENSING EVALUATOR NAME: Caitlynn Felias	TELEPHONE: 707-588-5039
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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