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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 496803470
Report Date: 12/02/2022
Date Signed: 12/02/2022 10:08:16 AM

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
10/25/2022 and conducted by Evaluator Victoria Bertozzi
COMPLAINT CONTROL NUMBER: 21-AS-20221025120858
FACILITY NAME:REDWOOD VISTA RESIDENTIAL CARE HOMEFACILITY NUMBER:
496803470
ADMINISTRATOR:ANGELICA MARTINEZFACILITY TYPE:
740
ADDRESS:8052 WHIPPOORWILL COURTTELEPHONE:
(707) 620-0243
CITY:WINDSORSTATE: CAZIP CODE:
95492
CAPACITY:6CENSUS: 6DATE:
12/02/2022
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Licensee, Angelica MartinezTIME COMPLETED:
10:17 AM
ALLEGATION(S):
1
2
3
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5
6
7
8
9
Staff not fingerprint cleared and/or associated
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst Bertozzi arrived unannounced to deliver findings regarding the above complaint allegation and met with Licensee, Angelica Martinez.

During investigation LPA conducted interviews, reviews staff files and made observations. Complaint alleges that current facility staff are not fingerprint cleared and associated to work at the facility indicating that the licensee is using fingerprint documentation from former staff to employ un-fingerprinted staff. Review of staff documented on the LIC500 Personnel Summary and review of the daily Covid screening of staff show only fingerprint cleared and associated staff have been working at this facility. Staff on shift during LPA's visit on November 3, 2022 was fingerprint cleared and provided LPA with their government issued identification card. Staff files reviewed during investigation showed staff that were fingerprint cleared and associated to the facility.

A finding that the complaint allegation that staff not fingerprint cleared and/or associated was unsubstantiated meaning that although the allegation may have happened there is not a preponderance of evidence to prove that the allegation occurred. No deficiencies cited.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Hope DeBenedettiTELEPHONE: (707) 588-5059
LICENSING EVALUATOR NAME: Victoria BertozziTELEPHONE: (707) 588-5087
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
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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