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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 496803657
Report Date: 05/21/2024
Date Signed: 05/21/2024 12:33:14 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, 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
03/29/2024 and conducted by Evaluator Marisol Cuadra
PUBLIC
COMPLAINT CONTROL NUMBER: 21-AS-20240329084803
FACILITY NAME:HOPE HOUSEFACILITY NUMBER:
496803657
ADMINISTRATOR:MOORE, SHANICEFACILITY TYPE:
735
ADDRESS:1550 N DUTTONTELEPHONE:
(707) 293-3138
CITY:SANTA ROSASTATE: CAZIP CODE:
95401
CAPACITY:12CENSUS: 12DATE:
05/21/2024
UNANNOUNCEDTIME BEGAN:
11:34 AM
MET WITH:Emiley Midyette (House Manager)TIME COMPLETED:
12:48 PM
ALLEGATION(S):
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9
-Facility staff not allowing the resident to leave the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct a complaint investigation and deliver findings regarding the above allegations and met with Emiley Midyette House Manager.

The Department received an allegation of facility staff not allowing the resident to leave the facility. Per reporting party, client (C1) was grounded by supervisor due to been accused of drinking alcohol, after they have been tested resulting in a reading of 00.00 negative for drinking. Based on records review, C1 was suspected to had been consuming alcohol during an outing, then the facility has tested them utilizing a breathalyzer that revealed that C1 had a reading of 0.73 for alcohol. However, the facility does not document readings from breathalyzer. Based on C1’s admission agreement signed on 10/10/21 by C1 indicates “coming into the house under the influence will result into placement on household for a week/meeting with case manager to discuss treatment”, meaning no passes or outings other than bible study and church due to findings of alcohol.
Continues on LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024
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
Control Number 21-AS-20240329084803
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: HOPE HOUSE
FACILITY NUMBER: 496803657
VISIT DATE: 05/21/2024
NARRATIVE
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Continued from LIC9099...

On 4/3/24 at 11am, facility staff held a meeting with C1’s placement agency about their findings, and it was agreed by C1 and Administrator to follow program rules and guidelines. Also, LPA was provided with two wellness contracts dated 11/21/23 and 3/22/24 due to C1 violated facility’s house rules and expectations by testing positive for alcohol at prior dates. Although, based on interviews conducted with staff and clients (C1, C2, C3 & C4), where it was revealed conflicting information about times where clients had been kept from accessing the community when it is determined that client’s health and safety is at risk if accessing the community without appropriate supervision or escorted by staff/volunteer. A finding that the complaint allegation of staff not allowing the resident to leave the facility is unsubstantiated meaning that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview conducted with house manager and a copy of this report was given.

SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2