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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 557004883
Report Date: 04/14/2022
Date Signed: 05/03/2022 03:51:05 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/08/2022 and conducted by Evaluator Sarah Hurt
COMPLAINT CONTROL NUMBER: 27-AS-20220208112637
FACILITY NAME:WATCHFACILITY NUMBER:
557004883
ADMINISTRATOR:DALY, CHRISTINEFACILITY TYPE:
775
ADDRESS:12801 CABEZUTTELEPHONE:
(209) 533-0510
CITY:SONORASTATE: CAZIP CODE:
95370
CAPACITY:140CENSUS: 43DATE:
04/14/2022
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Director of Program Services, Mica SuttonTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility violated residents personal rights by not allowing client to attend ADP
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit at 02:00 p.m. on April 14, 2022 to deliver findings on the allegations listed above. LPA met with Director of Program Services Mica Sutton and explained the purpose for today's visit.

Regarding the allegation the Facility violated residents’ personal rights by not allowing client to attend ADP. Based on LPA interviews and records reviewed the client was able to attend day program with all other clients when it re opened from the temporary shut down on February 14, 2022, therefore no client rights were violated. Therefore, this allegation is UNSUBSTANTIATED. A finding that a complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

No deficiencies were cited per Title 22 Regulations. An exit interview was conducted with Director of Program Services Mica Sutton and a copy of this report was left at the facility.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Sarah Hurt
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2022
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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