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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 496803241
Report Date: 07/17/2025
Date Signed: 07/17/2025 10:40:13 AM

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
06/03/2025 and conducted by Evaluator Marisol Cuadra
PUBLIC
COMPLAINT CONTROL NUMBER: 21-AS-20250603083138
FACILITY NAME:BROOKDALE CHANATEFACILITY NUMBER:
496803241
ADMINISTRATOR:PATRICIA GUSTINFACILITY TYPE:
740
ADDRESS:3250 CHANATE RDTELEPHONE:
(707) 575-7503
CITY:SANTA ROSASTATE: CAZIP CODE:
95404
CAPACITY:140CENSUS: 97DATE:
07/17/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Patricia Gustin (Executive Director/Administrator)TIME COMPLETED:
10:55 AM
ALLEGATION(S):
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-Staff not keeping an accurate record of resident’s payments.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct a complaint investigation and deliver the findings regarding the above allegation and met with Administrator Patricia Gustin.

The Department received an allegation of staff not keeping an accurate record of residents’ payments. Per Reporting Party when resident (R1) receives a bill for the month, R1 writes a check and walk it down to facility bookkeeper (S1) timely, but no receipt or acknowledgement is given to R1. However, the following month R1 would receive a late fee of $250.00, when R1 inquiries about it with S1 who instructs R1 to ignore it. Last month (May 2025), R1’s bill was $6,784.00 then receives a bill the following month for $13,985.52, and the responsible party doesn’t believe the facility is keeping an accurate record of R1’s payments resulting in late fees continuing to be added along with additional fees. Based on confidential interviews conducted with S1, last month (May 2025), there was a glitch in the system resulting in the rejection of checks submitted in-person and the system automatically generates by the 10th day of each month outstanding fees in the amount of $250 for those residents who do not submit a payment prior to the 10th of the month. Continue on LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025
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 2
Control Number 21-AS-20250603083138
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: BROOKDALE CHANATE
FACILITY NUMBER: 496803241
VISIT DATE: 07/17/2025
NARRATIVE
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Continued from LIC9099...

S1 was made aware of the system been down, so S1 notified R1 to ignore the late fees charges because the charges for late fees were going to be removed. Regarding additional fees, R1 was referred to the clinical department to address their concerns around them, because those charges are named “PSR”, which are based on R1’s needs, which fluctuates each month depending on different levels of care provided that are not determined by S1, the facility has a clinical department that evaluates resident’s level of care. Based on records review, the facility provided an account history report from 1/8/25 through the present are consistent and supporting the agreed amount of $6784 with late fees reversal in the amount of $250. A finding that the complaint allegation of staff not keeping an accurate record of resident’s payments is unsubstantiated meaning 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, therefore the allegation is UNSUBSTANTIATED.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2