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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486803645
Report Date: 06/04/2025
Date Signed: 06/04/2025 02:49:36 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
05/30/2025 and conducted by Evaluator Ali Deniz
COMPLAINT CONTROL NUMBER: 21-AS-20250530124825
FACILITY NAME:VACAVILLE MEMORY CAREFACILITY NUMBER:
486803645
ADMINISTRATOR:CAMILLE BROWNFACILITY TYPE:
740
ADDRESS:431 NUT TREE ROADTELEPHONE:
(707) 449-1350
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY:75CENSUS: 60DATE:
06/04/2025
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Administrator, Camille BrownTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff do not maintain a comfortable temperature inside of the facility
INVESTIGATION FINDINGS:
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At approximately 12:20PM, Licensing Program Analysts (LPAs) Deniz and Felias arrived unannounced to initate a Complaint Investigation regarding the above allegation and met with Administrator, Camille Brown.

During the course of the investigation, the Department requested and reviewed documents, conducted interviews, and made observations. There is an allegation that "Staff do not maintain a comfortable temperature inside of the facility." Complainant alleged that during a visit to the facility, it was extremely hot inside one of the homes and the outside temperature was 95F. Complainant also stated that the air conditioner has been broken for one year, so facility has placed fans on the floors to blow air however it was still very hot inside and residents complained of being hot, uncomfortable and sleepy due to the heat.

Continued on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Ali Deniz
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 21-AS-20250530124825
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: VACAVILLE MEMORY CARE
FACILITY NUMBER: 486803645
VISIT DATE: 06/04/2025
NARRATIVE
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Continued from LIC9099

Facility reported to Community Care Licensing (CCL) that one of their homes, Clark House, did not have their main air conditioning (AC) unit working. CCL Staff conducted a visit on 05/31/2025, where it was observed that the inside of Clark House was 77F. It was observed that each resident in Clark House had an individual AC unit that was operational and functioning. Clark House residents were observed to not be in distress (exhibiting red faces and/or sweating). The other 4 houses were also observed and found to have operating AC units. During visit conducted on 06/04/2025, it was observed that all 5 houses were at a comfortable temperature and none of the residents were observed to be in distress.

Based on observations made, this allegation is Unsubstantiated. A finding that the complaint allegation is Unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

No Deficiencies Cited during visit.

Exit interview conducted. Copy of report discussed and provided to Executive Director. Signature on form confirms receipt of documents.

SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Ali Deniz
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3