496801684-10-27-2023-21-AS-VBEI-CZ5TD9-20240103133759

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 496801684
Report Date: 10/27/2023
Date Signed: 10/27/2023 12:26:49 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
10/16/2023 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20231016112552

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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Staff did not provide medical attention to resident.
Staff yelled at resident.
Staff steals resident’s personal documents.
Staff unlawfully evicting resident.
Staff does not offer nutritious meals.

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, the facility ensured medical attention was provided to residents. Documentation shows resident was seen by emergency personnel after a fall and refused transport to the hospital. Resident is able to communicate and make their own descisions. Based on interviews conducted, LPA was not able to find supporting evidence that staff yell at residents. There are times when a staff raises their voice to be heard over other noises, but not to yell directly at a resident. Based on interviews conducted and observations of resident file management, LPA did not find evidence that staff are taking resident's personal documents. 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-20231016112552

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 observed resident carrying paperwork in a plastic bag that appeared to have been just stuffed into the bag in no organized order.
LPA reviewed eviction documentation regarding R1. LPA reviewed resident admission agreement and observed the eviction documentation was within regulation. The admission documentation outlines house rules and terms for eviction. Facility documentation shows R1 did not follow house rules. Based on records reviewed and observations, the facility offers nutritious meals as required. LPA observed food storage areas and found food is stored properly to prevent contamination. LPA reviewed menus and observed meals such as Hamburgers, chicken pot pie, spaghetti, pulled pork and chicken enchiladas offered to residents. When a resident does not prefer the main meal, they are always offered an alternative.

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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