<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 496803001
Report Date: 09/03/2021
Date Signed: 09/03/2021 01:26:13 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, 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
07/23/2021 and conducted by Evaluator Victoria Willis
COMPLAINT CONTROL NUMBER: 21-AS-20210723160856
FACILITY NAME:SARAH'S RETIREMENT HOME FOR DD SENIORSFACILITY NUMBER:
496803001
ADMINISTRATOR:ARAYA, SARAHFACILITY TYPE:
740
ADDRESS:791 MCCONNELL AVENUETELEPHONE:
(707) 528-6623
CITY:SANTA ROSASTATE: CAZIP CODE:
95404
CAPACITY:6CENSUS: 3DATE:
09/03/2021
UNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Administrator, Sarah ArayaTIME COMPLETED:
01:35 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff is intoxicated during work hours
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst Willis arrived unannounced to deliver findings regarding the above allegation and met with Administrator, Sarah Araya.

During investigation, LPA conducted interviews and reviewed documents. Complaint alleges that a staff member was intoxicated while at work indicating that staff has returned to the facility with beverage containers that appeared to be alcohol, has fallen asleep while on shift and has vomited. Other interviews conducted denied seeing staff appear intoxicated but some did observe or hear about staff vomiting. Those interviewed did not necessarily attribute staff getting sick to them being intoxicated.

A finding that the complaint allegation that staff is intoxicated during work hours was unsubstantiated meaning that although the allegation may have happened there is not a preponderance of evidence to prove that the allegation occurred. We have therefore dismissed the complaint.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Hope DeBenedetti
LICENSING EVALUATOR NAME: Victoria Willis
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2021
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