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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496803657
Report Date: 04/25/2024
Date Signed: 04/25/2024 02:08:07 PM

Document Has Been Signed on 04/25/2024 02:08 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:HOPE HOUSEFACILITY NUMBER:
496803657
ADMINISTRATOR/
DIRECTOR:
DEBBIE MCCULLOCHFACILITY TYPE:
735
ADDRESS:1550 N DUTTONTELEPHONE:
(707) 293-3138
CITY:SANTA ROSASTATE: CAZIP CODE:
95401
CAPACITY: 12CENSUS: 12DATE:
04/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:20 PM
MET WITH:Emiley Midyette (Program Manager)TIME VISIT/
INSPECTION COMPLETED:
02:23 PM
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Licensing Program Analyst (LPA) Cuadra arrived unannounced for the purpose of conducting a case management to follow up on SOC341 along with incident report regarding client (C1) for suspected financial abuse and met with facility Emiley Midyette, House Program Manager.

Per incident report, on 4/3/24 their clinical director filed an APS report regarding C1 for alleged financial abuse from an outside party not related to the facility. The facility staff have suspected that a financial abuse could happen in the near future if no further actions are taken. C1 has a history of people taken financial advantage of them. An individual (I1) started coming around C1 more frequently after the death of their parent. After a recent visit performed by I1, C1 who is conserved gave a copy to staff of a document that they were "told to sign" without consulting with their conservator. Currently, C1's finances are managed by a third party. I1 has approached staff requesting placement information about another client and stated their intent to attempt to get C1's conservatorship transfer to them. Per SOC341 report, on 4/2/24 I1 unsuccessfully attempted to request the facility staff to reimburse them the amount of $120 for expenses of C1 and inquired about C1's financial information. C1's responsible parties were notified including CCL.

During today's visit, LPA reviewed records and was informed that on 4/17/24 law enforcement showed up to the facility to investigate the incident (case number #24-4562). The facility notified all pertinent agencies as a precaution to protect C1's rights from anybody who could be attempting to financially abuse clients in care. The Department will review documents received.
No deficiencies cited during today's visit. Exit interview was conducted with Program Manager and a copy of this report was given.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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