535002328-10-21-2022-25-AS-TORZ-CKHR3M-20221024124010

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 535002328
Report Date: 10/21/2022
Date Signed: 10/21/2022 12:40:24 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/13/2022 and conducted by Evaluator Rebecca Knight

COMPLAINT CONTROL NUMBER: 25-AS-20221013083532

FACILITY NAME:	ALPINE HOUSE		FACILITY NUMBER:	535002328
ADMINISTRATOR:	SANDERS, LAURA		FACILITY TYPE:	735
ADDRESS:	250 MAIN STREET		TELEPHONE:	(530) 623-1200
CITY:	WEAVERVILLE	STATE: CA	ZIP CODE:	96093
CAPACITY:	6	CENSUS: 6	DATE:	10/21/2022
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Kimberly Werner - house supervisor		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Unlawful eviction - UNSUBSTANTIATED
Staff yells at resident(s). - UNSUBSTANTIATED

INVESTIGATION FINDINGS:

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10/21/2022 10:45 AM Licensing Program Analyst (LPA) Rebecca Knight, made an unannounced visit to the facility and met with Kimberly Werner, house supervisor. Administrator Laura Sanders was unavailable. The purpose of this visit was to open a complaint investigation. Prior to initiating the visit, LPA completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N95 Mask, gloves.

LPA interviewed the administrator by telephone. LPA interviewed 6 clients and 2 staff at the facility. LPA interviewed 2 staff by telephone.LPA obtained the following documents during the visit: client list, staff list with telephone numbers.
Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2022

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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Control Number 25-AS-20221013083532

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: ALPINE HOUSE	FACILITY NUMBER: 535002328
	VISIT DATE: 10/21/2022

NARRATIVE

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Unlawful eviction - UNSUBSTANTIATED

It was alleged that a client is being unlawfully evicted.

During client interviews it was learned that no clients have been evicted. 2 of 6 clients have been warned about eviction. One client due to non -payment of fees, and one due to behaviors which the client is working diligently on to mitigate.

5 of 5 staff stated they have not witnessed the administrator threaten to evict a client as a form of punishment.

Administrator stated they recently served a client a 30 day conditional eviction due to behaviors. Administrator stated if C1 can keep their behaviors in control they will not have to move from the facility.

Staff yells at residents - UNSUBSTANTIATED

It was alleged that staff yelled at Client 1 C1).

During client interviews 3 of 6 clients stated that staff had yelled at them.

4 of 4 staff interviewed stated they had not yelled at a client or witnessed any staff yell at a client. 1 of 4 staff stated that they have not witnessed staff yelling at a client but occasionally the manner in which some staff speak to the clients is disrespectful.

Administrator stated she has never yelled at a client and has not witnessed other staff yell at a client.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are UNSUBSTANTIATED.

An exit interview was conducted. A copy of the report was emailed to facility administrator Laura Sanders. No deficiency cited.

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2022

LIC9099 (FAS) - (06/04)

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