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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 496803300
Report Date: 12/17/2024
Date Signed: 12/17/2024 01:13:23 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
09/03/2024 and conducted by Evaluator Marisol Cuadra
PUBLIC
COMPLAINT CONTROL NUMBER: 21-AS-20240903132941
FACILITY NAME:FIVE PALMS CARE HOMEFACILITY NUMBER:
496803300
ADMINISTRATOR:ROBERTSON CIRINEOFACILITY TYPE:
740
ADDRESS:1217 LANCE DRIVETELEPHONE:
(707) 579-1739
CITY:SANTA ROSASTATE: CAZIP CODE:
95401
CAPACITY:23CENSUS: 16DATE:
12/17/2024
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Robertson Cirineo (Administrator)TIME COMPLETED:
01:28 PM
ALLEGATION(S):
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Resident was sexually abused by staff.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct a complaint investigation and deliver findings regarding the above allegations and met with Robertson Cirineo, Administrator.

It was alleged that resident was sexually abused by staff. During the course of this investigation, The Department investigator conducted interviews with staff, residents and other witnesses, and reviewed records associated to the involved resident (R1). Based on interviews conducted and records obtained the investigation revealed that staff (S1) has touched “the front of their.” R1 did not feel that S1’s intentions were “sexual” or that they “crossed the line.” R1 stated S1 called them beautiful and other complimentary names. Resident (R2) stated that on one occasion a male staff “grabbed both of their wrists,” to “silence their hands.” R2 also shared that they heard comments about rape from a female Caregiver. Staff and residents who were interviewed did not witness or experience inappropriate behavior from S1 or staff (S2) who were the only night staff around the time of the alleged sexual abuse.
Continued on LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024
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-20240903132941
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: FIVE PALMS CARE HOME
FACILITY NUMBER: 496803300
VISIT DATE: 12/17/2024
NARRATIVE
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Continued from LIC9099...

Licensee stated that staff are directed to ask the resident, or announce what they are going to do, prior to washing private areas of resident’s bodies. According to the Licensee, S1 had worked at the facility for about four to five years and R1’s allegation was the first complaint of sexual abuse that a resident had ever shared about S1. S1 adamantly denied the allegation to Licensee. Attempts to contact S1 were unsuccessful. According to staff, S1 did not have a cell phone, and they lived at the facility during their employment; therefore, no current address was available. Attempts to contact S1 at two former addresses were also unsuccessful. A finding that the complaint allegation occurs of resident was sexually abused by staff 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: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2