Complaint Investigation Report

216804022-12-18-2025-21-AS-KMOA-DNDM6Q-20251113082018

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SANTA ROSA RO , 1450 NEOTOMAS AVENUE, STE. 100

This is an official report of an unannounced visit/investigation of a complaint received in our office on

11/04/2025 and conducted by Evaluator Anthony Loera

COMPLAINT CONTROL NUMBER: 21-AS-20251104102911

Facility staff are not providing adequate supervision resulting in altercations between residents

On 12/18/2025, Licensing Program Analyst (LPA) Loera arrived unannounced to conduct a complaint investigation and delivering complaint findings. LPA arrived and met with Executive Director, Scott Davis. During the investigation, LPA reviewed records and made observations.

Compliant alleges, facility staff are not providing adequate supervision resulting in altercations between residents.

Based on LPAs observations and record reviews, the following determination had been made, resident (R1) was involved in an altercation with resident (R2) on 10/11/2025. Community Care Licensing (CCL) received an incident report on 10/17/2025, regarding R1 and R2, stating on 10/11/2025 around 4:15am, R1 was found yelling in the hallway for help and said R2 came into their room and “slapped them in the face”. Staff (S1) went into R1s room and found R2 still in the room and was still agitated and was not re-directable. Police were called to take a report and helped escort R2 back into their own room. No injuries were noted or visible.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

**Report amended as citation does not reflect allegation**