Senior Care Records.

Complaint Investigation Report

Clover Valley Guest Home, Upper Lake05/06/2025Licence 170107747

Census4
Date signed05/06/2025 10:46:36 AM
The inspector’s account

Based on interviews conducted, observations made, and record review, the allegation listed above is SUBSTANTIATED. A finding that a complaint allegation is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met.

Deficiency is cited from Title 22 Regulations, Division 6.

Exit interview conducted. Copy of report discussed and provided to Licensee, whose signature on form confirms receipt of documents. Appeal rights provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction