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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701489
Report Date: 04/16/2025
Date Signed: 08/15/2025 10:12:01 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
04/07/2025 and conducted by Evaluator Renee Campbell
COMPLAINT CONTROL NUMBER: 27-AS-20250407115421
FACILITY NAME:CASA DORISFACILITY NUMBER:
342701489
ADMINISTRATOR:CLARK, BEATRICEFACILITY TYPE:
740
ADDRESS:8533 LIQUID AMBER WAYTELEPHONE:
(916) 670-0370
CITY:ELK GROVESTATE: CAZIP CODE:
95757
CAPACITY:6CENSUS: DATE:
04/16/2025
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Beatrice Clark, AdministratorTIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff member yells at resident(s) in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
This amendment was made on 08/12/2025 to correct the name of the licensee LPA met with.

On 04/16/2025, Licensing Program Analyst, Renee Campbell arrived to the facility unannounced regarding a new complaint. LPA Campbell met Admin Beatrice Clark & explained the purpose of the visit.

Regarding the allegation that staff members yell at residents in care, after interviewing X2 and X3, there were no reports that staff yelled at residents other than to be heard. No staff are reported to have shouted at residents in an abusive disrespectful manner.
Based on all the information collected by the Department there is not a preponderance of evidence to prove the allegation occurred, therefore this allegation is UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2025
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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