496800549-12-6-2024-21-AS-BMOS-DCFNVH-20241230094754

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 496800549
Report Date: 12/06/2024
Date Signed: 12/06/2024 10:35:05 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
09/10/2024 and conducted by Evaluator Dina Alviso

PUBLIC

COMPLAINT CONTROL NUMBER: 21-AS-20240910102359

FACILITY NAME:	ALVAREZ FAMILY HOME		FACILITY NUMBER:	496800549
ADMINISTRATOR:	MUTUNGA, EMMA		FACILITY TYPE:	740
ADDRESS:	2185 FLORAL WAY		TELEPHONE:	(707) 545-6464
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95403
CAPACITY:	6	CENSUS: 4	DATE:	12/06/2024
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Emma Mutunga-Administrator		TIME COMPLETED:	10:50 AM

ALLEGATION(S):

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Clients hygiene care needs are not being met
Personal Rights Violation

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Alviso and Stevenson delivered findings of the complaint investigation, on 12/5/24 at approximately 9:20am, and met with Administrator Emma Mutunga.

LPA reviewed client C1 records, facility records, and other information obtained in the investigation. LPA toured the facility. The facility was observed to be clean and orderly. The food supply was observed to be sufficient.

The reporting party (RP) alleges that client’s hygiene care needs are not being met, and client’s personal rights are being violated. C1 was admitted 8/15/24 to the facility; C1 does attend a day program, as of 8/19/24. Per review of records, information obtained, and interviews with staff, and other related parties, the investigation revealed the following: C1 has had some history of hygiene needs and concerns, and C1 does need assistance with hygiene care, including showering, grooming, and dental hygiene. S1 stated that C1 needs more assistance than stated when C1 was placed into care. S1 stated the current observed behaviors of C1 in regard to client’s hygiene care, show that the client needs higher level of assistance from staff, but it has been difficult providing the needed services when the client refuses.
Continued on LIC9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Dina Alviso
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)

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Control Number 21-AS-20240910102359

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: ALVAREZ FAMILY HOME	FACILITY NUMBER: 496800549
	VISIT DATE: 12/06/2024

NARRATIVE

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Continued from LIC9099..
S1 stated that they would go back and forth trying to get C1 to agree to shower and/or to allow staff to provide necessary personal hygiene care needs while C1 showers. Per interview, C1 would say “no or tomorrow I will shower” this made it difficult to get C1's hygiene care provided to them. S1 stated that they have been able to get C1 showered and allowing staff to help provide more hygiene care assistance to them. S1 stated C1 received a needed haircut due to having some large knots in their hair; Family member of C1 helped with getting C1 agree to the haircut. Per review of records and interviews, C1’s case manager, with the Regional Center, was notified of C1’s hygiene issues, and facility’s plan to encourage C1 and provide all needed hygiene care; C1’s case manager has no concerns with client’s placement in the facility and/or concerns with client’s hygiene care at this time. There was no information obtained during the investigation to support a violation had occurred regarding the allegation.

Per investigation and interviews, C1 does have access to the facility phone and can contact other individuals, including their family members; Per staff S1, staff will help assist the client as needed regarding making calls and C1 may speak privately on calls. S1 stated they are receiving support from the regional center regarding C1’s needs and services at this time. Per information obtained and interviews with other related parties, C1 has been observed to have good hygiene at this time, and currently there are no hygiene concerns with C1’s needs being met. There was no information obtained during the investigation to support a violation had occurred regarding the allegation.

Based on the interviews, record/document reviews, and related information obtained during the investigation, the allegations of “client’s hygiene care needs are not being met, and client’s personal rights are being violated” are Unsubstantiated, meaning that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

No deficiencies cited.
Exit interview was conducted with the Administrator Emma Mutunga.

SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Dina Alviso
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)

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