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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 216804066
Report Date: 11/24/2025
Date Signed: 11/24/2025 04:12:04 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
11/14/2025 and conducted by Evaluator Anthony Loera
COMPLAINT CONTROL NUMBER: 21-AS-20251114115936
FACILITY NAME:BLUFFS AT HAMILTON HILL, THEFACILITY NUMBER:
216804066
ADMINISTRATOR:ACUMABIG. JOSEFACILITY TYPE:
740
ADDRESS:1 HAMILTON HILL DRIVETELEPHONE:
(415) 889-8026
CITY:NOVATOSTATE: CAZIP CODE:
94949
CAPACITY:95CENSUS: 82DATE:
11/24/2025
UNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Melon Rivera, Executive DirectorTIME COMPLETED:
04:20 PM
ALLEGATION(S):
1
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9
Staff did not ensure residents confidential information was maintained
INVESTIGATION FINDINGS:
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2
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9
10
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13
On 11/24/2025, Licensing Program Analyst (LPA) Loera conducted an unannounced visit for the purpose of delivering complaint findings. LPA arrived and met with Executive Director, Melon Rivera. During the course of the investigation, LPA conducted interviews and made observations.
Based upon department record review and interviews conducted, information provided was contradicting with a lack of corroborating evidence to support the allegation. Reporting Party (RP) states a discussion about a resident transitioning off hospice was held in a common area violating resident rights. RP also stated no name was overheard. Interviews conducted reveal three out of four residents have not heard staff speaking loudly, revealing residents’ confidential information. One out of four residents stated they had heard a conversation about a resident transitioning out of hospice but did not hear any resident name being mentioned. The department is unable to find enough evidence to support the allegation as statements given did not hear a name of a resident being mentioned during the alleged discussion.
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: 11/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/24/2025
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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