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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 216803317
Report Date: 07/14/2023
Date Signed: 07/14/2023 02:33:18 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 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
09/12/2022 and conducted by Evaluator Cheyenne McCambridge
PUBLIC
COMPLAINT CONTROL NUMBER: 21-CR-20220912112614
FACILITY NAME:CICADA-GREENBRAEFACILITY NUMBER:
216803317
ADMINISTRATOR:CAMATOG, NOELFACILITY TYPE:
730
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:6CENSUS: 5DATE:
07/14/2023
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Noel CamatogTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Staff handled minor in a rough manner
Staff made inappropriate comments to client in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cheyenne McCambridge conducted a follow-up complaint inspection to the Facility and met with Administrator Noel Camatog. The purpose of the inspection was to deliver the finding for the above complaint allegations.
During the course of investigating this allegation LPA McCambridge interviewed staff, observed clients, and reviewed files. LPA was unable to interview clients due to the fact that the clients are non-verbal. LPA observed clients to be safe and accorded dignity during the inspection. During interviews staff stated that that staff have never harmed or spoked inappropriately to clients. Without being able to speak to the clients to corroborate the allegatons LPA determined the allegations to be unsubatantiated.
Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the staff administered cold medicine to a minor that is not ill; therefore, the above allegation is unsubstantiated.
Appeal Rights were provided and discussed with the facility and no deficiencies were cited.
Exit interview was conducted and a copy of the report was left with the Administration Noel Camatog.
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Isabel Diego
LICENSING EVALUATOR NAME: Cheyenne McCambridge
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2023
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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