496801684-10-27-2023-21-AS-VBEI-CYWVVW-20231227154657

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 496801684
Report Date: 10/27/2023
Date Signed: 10/27/2023 12:27:41 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
10/09/2023 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20231009163356

FACILITY NAME:	AA BEST CARE HOMES		FACILITY NUMBER:	496801684
ADMINISTRATOR:	AQUINO, NICANOR		FACILITY TYPE:	740
ADDRESS:	857 HEARN AVE.		TELEPHONE:	(707) 546-8413
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95407
CAPACITY:	40	CENSUS: 29	DATE:	10/27/2023
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Charito Santos		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Personal Rights
Facility not maintaining records
Staff did not keep facility free from pests.
Water temperature not within regulation
Medications not given as prescribed

INVESTIGATION FINDINGS:

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At approximately 8:30AM, Licensing Program Analyst Chris Arnhold arrived at this facility unannounced, to conduct an investigation into the above allegations. LPA met with Administrative Assistant Charito Santos, reviewed records, interviewed residents and staff and received copies of documents. Based on records reviewed and interviews conducted, LPA did not find any evidence to support the allegation that staff are violating the personal rights of residents. LPA interviewed residents and learned staff are respectful and provide assistance when asked. Local law enforcement investigated a case regarding an allegation that a staff hit a resident. The case was unfounded. Based on records reviewed and documentation received, there is no evidence that staff are taking documents from residents. LPA compared documents in the facility file with documents received from resident and found they match. LPA reviewed resident records and found the required documentation. Continued on LIC9099-C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Bethany Moellers	TELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Christopher Arnhold	TELEPHONE: (707) 588-5084
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2023

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-20231009163356

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: AA BEST CARE HOMES	FACILITY NUMBER: 496801684
	VISIT DATE: 10/27/2023

NARRATIVE

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LPA toured the building and grounds and did not find evidence of pests. Based on interviews conducted, facility has had pests in the past, but facility purchased a machine to prevent future infestations. LPA tested the water temperature at various locations in the facility. Water temperatures were between 105 and 120 degrees as regulation dictates. The bathrooms were clean and not malodorous. LPA reviewed medication administration records and centrally stored logs. LPA observed prescribed medication is given as ordered. LPA observed medication storage was secure and orderly.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.

SUPERVISOR'S NAME: Bethany Moellers	TELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Christopher Arnhold	TELEPHONE: (707) 588-5084
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2023

LIC9099 (FAS) - (06/04)

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