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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 315920079
Report Date: 01/14/2026
Date Signed: 01/14/2026 12:47:25 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/02/2025 and conducted by Evaluator Kevin Mknelly
COMPLAINT CONTROL NUMBER: 59-AS-20251202074543
FACILITY NAME:IRIS HOME CAREFACILITY NUMBER:
315920079
ADMINISTRATOR:PETERSON, BRIGITTEFACILITY TYPE:
740
ADDRESS:1302 HILLVIEW CTTELEPHONE:
(279) 900-8815
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY:6CENSUS: 4DATE:
01/14/2026
UNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:BridgetteTIME COMPLETED:
12:55 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident was involuntarily transferred
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
 On 1/14/26, Licensing Program Analyst (LPA) Kevin Mknelly conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with Admin.
LPA conducted records review and interviews.
LPA is unable to find and or meet the preponderance, per policy.
Investigation found that R1 resided at this home for a short time. During R1's time in the home admisiion paperwork and payment were not yet completed. Though R1's condition had not changes, emergency responders were called and agreed to take R1 to the hospital. From the hospital, arrangement was made to transport R1 to a diffferent facility. LPA conducted a collotaeral visit to R1's new home and found R1 to not suffer and negative effects from the transfer. Licensee denied evicting R1 nor deny R1 a return from hospitalization.
As a result of this investigation, LPA finds allegation to be (US)Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
Exit interview with administrator.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2026
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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