236804089-4-29-2025-21-AS-KMOA-DGASPX-20250502140353

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 236804089
Report Date: 04/29/2025
Date Signed: 04/29/2025 02:11:41 PM

Unfounded

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
04/25/2025 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20250425094723

FACILITY NAME:	OCEANSIDE CARE HOME LLC		FACILITY NUMBER:	236804089
ADMINISTRATOR:	VALESIA COLE		FACILITY TYPE:	740
ADDRESS:	535 E. CHESTNUT STREET		TELEPHONE:	(707) 409-5004
CITY:	FORT BRAGG	STATE: CA	ZIP CODE:	95437
CAPACITY:	6	CENSUS: 5	DATE:	04/29/2025
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Candice Mckoy		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff are not addressing issues of mold in the facility

INVESTIGATION FINDINGS:

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At approximately 1:30PM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to open an investigation into the above allegation. LPA met with care giver Candace Mckoy and toured the home. LPA observed black marking's on two walls inside the facility. LPA spoke with Administrator Valesia Cole via telephone and was informed they recently moved furniture around inside the building. LPA verified the black marks on the walls correspond to a piece of furniture that was previously in that location. The other mark corresponds to the wheels of a wheelchair. LPA inspected the bathrooms and showers of the facility and did not find evidence of mold or other discolorations.

This agency has investigated the above allegation. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2025

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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