Senior Care Records.

Complaint Investigation Report

Sycamore Home, Novato11/18/2024Licence 216803711

Census4
Date signed11/18/2024 10:49:34 AM
The inspector’s account

216803711-11-18-2024-21-AS-KMOA-DB8M3C-20241121081455

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

10/15/2024 and conducted by Evaluator Anthony Loera

COMPLAINT CONTROL NUMBER: 21-AS-20241015153841

On 11/18/2024, Licensing Program Analyst (LPA) Loera and Licensing Program Manager (LPM) Mota conducted an unannounced visit for the purpose of delivering complaint findings. LPA and LPM arrived and met with administrator, Willie Hogan. During the course of the investigation, LPA and LPM toured the facility, reviewed records and video, conducted interviews with staff and outside parties, and made observations.

Compliant alleges, staff (S1) physically abused client (C1) causing a bruise to their right chest.

Based upon department interviews with staff and police, information provided was contradicting with a lack of corroborating evidence to support the allegation. In addition, the department and outside agencies were unable to identify a witness to the incident.

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.

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