496801929-2-6-2024-21-AS-CMAZ-D2F2DR-20240213161845

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 496801929
Report Date: 02/06/2024
Date Signed: 02/06/2024 02:54:21 PM

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
12/15/2023 and conducted by Evaluator Christi Coppo

COMPLAINT CONTROL NUMBER: 21-AS-20231215094751

FACILITY NAME:	FRIENDS HOUSE		FACILITY NUMBER:	496801929
ADMINISTRATOR:	ROBERT RUBIO		FACILITY TYPE:	741
ADDRESS:	684 BENICIA DRIVE		TELEPHONE:	(707) 538-0152
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95409
CAPACITY:	145	CENSUS: 7	DATE:	02/06/2024
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Korina Weatherson, Sales Manager		TIME COMPLETED:	03:02 PM

ALLEGATION(S):

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Staff are not preventing resident from smoking in the facility
Staff are not providing a comfortable environment for resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christi Coppo arrived unannounced at the facility and met with Korina Weatherson, Sales Manager to deliver findings regarding the complaint allegation above. Administrator Robert Rubio was not able to come to the facility, but was present via telephone and gave authorization for Korina Weatherson, Sales Manager to sign the report.

Staff are not preventing resident from smoking in the facility--It is alleged by Reporting Party that staff are not preventing resident from smoking in the facility. Reporting party reported knowledge of a resident smoking in unauthorized areas adding that the facility is a non-smoking facility. Per LPA conversation with Administrator, they have done the following to address smoking at the facility:
• Conduct Care conference with resident and spouse to address allegations of smoking
• Provided an alternative location away from residences for resident to smoke that is more than 25 feet away from any residence, as required by the County of Sonoma ordinance (chapter 32)

Continued on 9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Bethany Moellers	TELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Christi Coppo	TELEPHONE: (707) 588-5054
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024

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-20231215094751

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: FRIENDS HOUSE	FACILITY NUMBER: 496801929
	VISIT DATE: 02/06/2024

NARRATIVE

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Continued from 9099...

A finding that the complaint allegation that staff are not preventing resident from smoking in the facility is unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is UNSUBSTANTIATED.

Staff are not providing a comfortable environment for resident---It is alleged by Reporting Party that staff are not providing a comfortable environment for resident as evidenced by resident smoking in unauthorized areas, which results in other resident(s) being affected by the smoke. Per LPA interviews with potentially affected residents, they acknowledge that a neighbor is smoking but are not bothered by it. Other residents report never smelling smoke or observing residents smoking. LPA was unable to obtain any information to support that staff are not providing a comfortable environment for residents.

A finding that the complaint allegation that that staff are not providing a comfortable environment for resident is unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is UNSUBSTANTIATED.

SUPERVISOR'S NAME: Bethany Moellers	TELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Christi Coppo	TELEPHONE: (707) 588-5054
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024

LIC9099 (FAS) - (06/04)

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