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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 286802019
Report Date: 02/17/2022
Date Signed: 02/17/2022 12:01:50 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
02/15/2022 and conducted by Evaluator Erik Gonzalez Campos
COMPLAINT CONTROL NUMBER: 21-AS-20220215144846
FACILITY NAME:LINDA FALLS GUEST HOME 1FACILITY NUMBER:
286802019
ADMINISTRATOR:SACRO, NORBERTFACILITY TYPE:
740
ADDRESS:755 LINDA FALLS TERRACETELEPHONE:
(707) 963-1440
CITY:ANGWINSTATE: CAZIP CODE:
94508
CAPACITY:6CENSUS: 5DATE:
02/17/2022
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator, Norbert SacroTIME COMPLETED:
12:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Unlawful eviction
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Erik Gonzalez Campos arrived unannounced on 02/17/2022 to initiate complaint investigation regarding the allegation above. LPA met with Norbert Sacro, Administrator.

There is an allegation of an unlawful eviction of resident. Administrator indicated R1 was transported to the hospital on 02/06/2022 for refusing to eat or drink. At the hospital R1 tested positive for COVID. Administrator stated that his last contact with the hospital regarding R1 was on either 02/08/2022 or 02/09/2022. Reporting Party indicated that they had not been able to reach facility to discuss R1's return. LPA followed up with the hospital who informed LPA that R1 was cleared to return to the facility. Administrator indicated that he was hesitant to readmit R1 because of his condition. During the inspection, the administrator called the hospital and had a conversation with hospital staff regarding R1. Hospital and administrator made arrangements to have R1 return to the facility on 02/17/2022. Although the allegation may be valid, there is not a preponderance of evidence to prove the alleged violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Erik Gonzalez Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
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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