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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 496801684
Report Date: 02/13/2025
Date Signed: 02/13/2025 01:52:23 PM

Substantiated


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
01/02/2025 and conducted by Evaluator Marisol Cuadra
PUBLIC
COMPLAINT CONTROL NUMBER: 21-AS-20250102163018
FACILITY NAME:AA BEST CARE HOMESFACILITY NUMBER:
496801684
ADMINISTRATOR:AQUINO, NICANORFACILITY TYPE:
740
ADDRESS:857 HEARN AVE.TELEPHONE:
(707) 546-8413
CITY:SANTA ROSASTATE: CAZIP CODE:
95407
CAPACITY:40CENSUS: 24DATE:
02/13/2025
UNANNOUNCEDTIME BEGAN:
12:47 PM
MET WITH:Charito Santos (Administrative Assistant)TIME COMPLETED:
02:06 PM
ALLEGATION(S):
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-Staff did not keep residents free from bed bugs.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Cuadra and Deniz arrived unannounced to conduct a complaint investigation and deliver findings regarding the above allegations and met with Charito Santos, Administrative Assistant.
The Department received an allegation of staff did not keep residents free from bed bugs. The reporting party stated that resident (R1) was observed to have a bug infestation and an infection. LPA conducted 10-day visit on 1/7/25 obtained pertinent records and conducted interviews with Administrative Assistant. The Administrative Assistant told LPA that it had been hard to get rid of bed bugs, but they are treating resident’s rooms in a regular basis. However, based on LPA’s records review of facility internal temperature logs, it revealed that the last time they have treated resident’s rooms was on May 2024. Per Administrative Assistant, the staff have been forgetting to maintain the log in a regular basis, but R1’s room have been treated after been notified of the presence and lack of treatment of bedbugs in the facility. 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), is cited on the attached LIC 9099D. Appeal Rights Given. An immediate civil penalty in the amount of $250 will be issued for repeated violation within the last 12-month period.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025
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 2
Control Number 21-AS-20250102163018
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/13/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/14/2025
Section Cited
CCR
1569.269(a)(5)
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§1569.269 Enumerated rights; severability (a) Residents of RCFE shall have all of the following rights: (5) To be accorded safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement has not been met as evidence by:
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Licensee agrees to submit a plan/schedule to ensure facility is following up on resident’s needs, observation of the resident and treating all resident's rooms timely to CCL by POC due date. ** Civil Penalty assessed in the amount of $250.
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Based on LPA record review and interviews conducted the facility did not ensure R1 was accorded safe, healthful, and comfortable accommodations which resulted in R1 have a bug infestation which poses an immediate health and safety risk to residents 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: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2