496801929-1-8-2021-21-AS-CMAZ-BX4RXN-20210109122500

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 496801929
Report Date: 01/06/2021
Date Signed: 01/08/2021 10:03:47 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/09/2020 and conducted by Evaluator Kimberley Mota

COMPLAINT CONTROL NUMBER: 21-AS-20201209164348

FACILITY NAME:	FRIENDS HOUSE		FACILITY NUMBER:	496801929
ADMINISTRATOR:	ALLEN, CLARA		FACILITY TYPE:	741
ADDRESS:	684 BENICIA DRIVE		TELEPHONE:	(707) 538-0152
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95409
CAPACITY:	145	CENSUS: 5	DATE:	01/06/2021
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Michael Cataldo		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff did not ensure resident received transportation.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mota met with Michael Cataldo on this date for the purpose of delivering findings on the above captioned complaint allegation. The visit was conducted via tele-visit due to the COVID -19 precautions. Complainant alleges that staff did not ensure resident received transportation.

During the course of the investigation, this Department has taken statements from staff and complainant. After obtaining the current Sonoma County Public Health officer Order No. C19-02, amended 11/23/2020, Complainant alleges that the facility will not provide transportation for the purpose of purchasing groceries. The facility has developed a plan of providing this service on behalf of the residents due to the current Shelter in Place order issued by the Sonoma County Department of Public Health issued 11/23/2020.
Continued on 9099-C

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Carla Martinez	TELEPHONE: (707) 588-5079
LICENSING EVALUATOR NAME: Kimberley Mota	TELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2021

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-20201209164348

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: FRIENDS HOUSE	FACILITY NUMBER: 496801929
	VISIT DATE: 01/06/2021

NARRATIVE

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Page 4 of the county order states "Independent Living Residents should continue to shelter in their places of residence to slow the spread of COVID-19 to the maximum extent possible". The facility does not prohibit Independent Living residents from using other forms of transportation to go into the community to visit stores of their own choosing.

Complainant and facility agree that there is no contractual agreement that transportation for the purpose of purchasing groceries is in place.

This agency has investigated the complaint alleging staff did not ensure resident received transportation. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis

SUPERVISOR'S NAME: Carla Martinez	TELEPHONE: (707) 588-5079
LICENSING EVALUATOR NAME: Kimberley Mota	TELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2021

LIC9099 (FAS) - (06/04)

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