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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 216804066
Report Date: 04/10/2025
Date Signed: 04/10/2025 03:23:21 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
04/07/2025 and conducted by Evaluator Anthony Loera
COMPLAINT CONTROL NUMBER: 21-AS-20250407170351
FACILITY NAME:BLUFFS AT HAMILTON HILL, THEFACILITY NUMBER:
216804066
ADMINISTRATOR:LOMELI. LISA MFACILITY TYPE:
740
ADDRESS:1 HAMILTON HILL DRIVETELEPHONE:
(415) 889-8026
CITY:NOVATOSTATE: CAZIP CODE:
94949
CAPACITY:95CENSUS: 86DATE:
04/10/2025
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Karina Vasquez, Business Director
Lori Spencer, Regional Director		TIME COMPLETED:
03:35 PM
ALLEGATION(S):
1
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5
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7
8
9
Staff are not adequately addressing resident's fall risk.
INVESTIGATION FINDINGS:
1
2
3
4
5
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7
8
9
10
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12
13
On 04/10/2025, Licensing Program Analyst (LPA) Loera conducted an unannounced visit for the purpose of initiating a complaint investigation regarding the above complaint and delivering complaint findings. LPA arrived and met with Karina Vasquez, Business Director. During the investigation, LPA reviewed records, conducted interviews and made observations.

Compliant alleges, Staff are not adequately addressing resident's fall risk.

Based upon department interviews, information provided was contradicting with a lack of corroborating evidence to support the allegation. Per interviews conducted, facility has caregivers assiting with Resident's (R1) care as checking on R1 every hour and explored options for one-to-one care.

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.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Anthony Loera
LICENSING EVALUATOR SIGNATURE:

DATE: 04/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2025
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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