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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 496800179
Report Date: 10/07/2025
Date Signed: 10/07/2025 10:51:38 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
10/06/2025 and conducted by Evaluator Robert Frank
COMPLAINT CONTROL NUMBER: 21-AS-20251006095932
FACILITY NAME:WINDSOR HOUSEFACILITY NUMBER:
496800179
ADMINISTRATOR:GACHU, MARYLISFACILITY TYPE:
735
ADDRESS:1386 SANDERS ROADTELEPHONE:
(707) 838-9489
CITY:WINDSORSTATE: CAZIP CODE:
95492
CAPACITY:4CENSUS: 2DATE:
10/07/2025
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Marylis Gachu, Administrator
Darcy Harlan, Staff Member		TIME COMPLETED:
11:10 AM
ALLEGATION(S):
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Staff do not properly safeguard firearms from the clients
INVESTIGATION FINDINGS:
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At approximately 9:10 AM, Licensing Program Analyst (LPA) Robert Frank and Licensing Program Manager (LPM) Victoria Bertozzi arrived unannounced to initiate a Complaint Investigation regarding the above allegation and to deliver findings on one (1) of the allegations and met with facility Administrator Marylis Gachu and Staff member Darcy Harlan.

In conjunction with the Sonoma County Sheriffs office LPA and LPM inspected the staff living quarters. LPA observed that there were two (2) unsecured firearms (rifles) in the staff living quarters. LPA further observed that the two (2) firearms were unsecured and that one (1) of the firearms was loaded with ammunition.

Continued on 9099-C...


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Robert Frank
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
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-20251006095932
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: WINDSOR HOUSE
FACILITY NUMBER: 496800179
VISIT DATE: 10/07/2025
NARRATIVE
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...Continued from 9099

California Code of Regulations (CCR) 80087 Buildings and Grounds states the following:

(g) Disinfectants, cleaning solutions, poisons, firearms and other items that could pose a danger if readily available to clients shall be stored where inaccessible to clients.

(1) Storage areas for poisons, and firearms and other dangerous weapons shall be locked.

(2) In lieu of locked storage of firearms, the licensee may use trigger locks or remove the firing pin.

(A) Firing pins shall be stored and locked separately from firearms.

(3) Ammunition shall be stored and locked separately from firearms.

Based on LPA’s observations, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 Chapter 8, are being cited on the attached 9099D.


Exit interview conducted. Copy of LIC 9099, LIC 9099D, Plan of Corrections (POC) and Appeal Rights discussed and provided to facility Administrator Marylis Gachu and Staff member Darcy Harlan. Signature on form confirms receipt of documents.
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Robert Frank
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 21-AS-20251006095932
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: WINDSOR HOUSE
FACILITY NUMBER: 496800179
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/08/2025
Section Cited
CCR
80087(g)(3)
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80087 Buildings and Grounds (g)Disinfectants, cleaning solutions, poisons, firearms and other items that could pose a danger if readily available to clients shall be stored where inaccessible to clients. (3)Ammunition shall be stored and locked separately from firearms. This requirement is not met as evidenced by:
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Licensee will secure all firearms in the facility. Staff member Darcy Harlan stated that the facility will purchase a firearm safe. Facility is to provide photographic proof that the firearms are secure and unloaded to Community Care Licensing by POC due date of 10/8/2025.
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Based on observation, the licensee did not comply with the section cited above in that two (2) firearms, one (1) of which was loaded were observed to be unsecured which poses an immediate health, safety or 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: Robert Frank
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4