496803860-4-17-2024-21-AS-BMOS-D6JM42-20240624091602

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 496803860
Report Date: 04/17/2024
Date Signed: 04/17/2024 06:07:23 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
03/01/2024 and conducted by Evaluator Dina Alviso

PUBLIC

COMPLAINT CONTROL NUMBER: 21-AS-20240301093451

FACILITY NAME:	CLEARWATER AT SONOMA HILLS		FACILITY NUMBER:	496803860
ADMINISTRATOR:	O'SULLIVAN, JANNA		FACILITY TYPE:	740
ADDRESS:	710 ROHNERT PARK EXPRESSWAY E		TELEPHONE:	(707) 710-7385
CITY:	ROHNERT PARK	STATE: CA	ZIP CODE:	94928
CAPACITY:	114	CENSUS: 89	DATE:	04/17/2024
		UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Janna O'Sullivan- Administrator		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff force residents to take showers.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs), Alviso and Florio, conducted a complaint inspection, on 4/17/24 at approximately 8:40am, and met with Administrator Janna O'Sullivan, and Health Services Director Janice Foster.
LPAs requested facility records, including staff and resident files. LPAs reviewed all records. LPAs interviewed staff, and other related parties regarding the allegation. The reporting party (RP) alleges "staff force residents to take showers." The investigation revealed that resident (R1) has a care plan that includes assistance with showers. Resident is on a shower schedule, but per interviews R1 refuses many times to take their showers regularly and/or as scheduled; Per interviews, staff will offer R1 their shower, and if refused, the staff will come back after a short time and ask R1 again. Staff deny forcing any residents to take a shower, per interviews. The investigation found that there was differing information obtained per records, interviews, and per information provided by the reporting party. There was no information obtained to support a violation had occurred regarding the allegation. Based on the interviews, record/document reviews, and related information obtained during the investigation, the allegation "Staff force residents to take showers." is Unsubstantiated, meaning that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.
No deficiencies cited. Exit interview was conducted with the Administrator.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Hope DeBenedetti	TELEPHONE: (707) 588-5059
LICENSING EVALUATOR NAME: Dina Alviso	TELEPHONE: (707) 588-5082
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

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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