496802025-3-17-2021-21-AS-KMOA-BZFU86-20210325152102

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 496802025
Report Date: 03/17/2021
Date Signed: 03/17/2021 04:17:22 PM

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
03/15/2021 and conducted by Evaluator Christopher Arnhold

PUBLIC

COMPLAINT CONTROL NUMBER: 21-AS-20210315112222

FACILITY NAME:	BROOKDALE WINDSOR		FACILITY NUMBER:	496802025
ADMINISTRATOR:	WATSON, WENDY		FACILITY TYPE:	740
ADDRESS:	907 ADELE DR		TELEPHONE:	(707) 837-8785
CITY:	WINDSOR	STATE: CA	ZIP CODE:	95492
CAPACITY:	80	CENSUS:	DATE:	03/17/2021
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Wendy Watson		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Facility in disrepair.

INVESTIGATION FINDINGS:

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At approximately 12:30PM, Licensing Program Analyst (LPA) Chris Arnhold contacted Executive Director Wendy Watson to open an investigation into the above allegation. This visit is being conducted via telephone due to Covid-19 precautions. LPA interviewed Wendy regarding any repairs or alterations to the building. Wendy stated there has been no work done or planned for the facility. The city of Windsor water department came to the facility on 03/15/2021 to inspect and test the facilities water supply and found no problems.

This agency has investigated the above allegation. 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.
No citations issued.
Original Signature on file.

Unfounded

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: 03/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2021

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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