<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 496803311
Report Date: 07/03/2024
Date Signed: 07/03/2024 11:34:47 AM

Unfounded


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
06/26/2024 and conducted by Evaluator Dina Alviso
PUBLIC
COMPLAINT CONTROL NUMBER: 21-AS-20240626114916
FACILITY NAME:PLATINUM RESIDENTIAL CARE HOMEFACILITY NUMBER:
496803311
ADMINISTRATOR:SHAUGHNESSEY, MERAFACILITY TYPE:
740
ADDRESS:1972 DENNIS LANETELEPHONE:
(707) 757-8607
CITY:SANTA ROSASTATE: CAZIP CODE:
95403
CAPACITY:6CENSUS: 6DATE:
07/03/2024
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Janine Sorrenson-Lead CaregiverTIME COMPLETED:
11:45 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Medications are accessible to residents in care

Staff force residents to shower

Staff did not safeguard residents' personal belongings
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Alviso conducted a complaint inspection, on 7/3/2024 at approximately 9:45am, and met with Lead Caregiver, has a current Administrator certificate. Caregivers, Jordan and Chris were on duty at the facility.
LPA reviewed facility record of all facility residents in care.The LPA conducted interviews with staff, and other related parties. LPA conducted an interview with the Licensee/Administrator who confirmed that residents, R1 and R2, are not residents who reside at the facility, Platinum Residential. LPA obtained copies of facility records. Investigation revealed that residents, R1 and R2, are not residents of the facility, and this investigation/complaint is not regarding resident care at Platinum Residential Care Home.
Based on the interviews, record/document reviews, and related information obtained during the investigation, the allegations "medications are accessible to residents in care, staff force residents to shower, staff did not safeguard residents' personal belongings" are Unfounded.We have found that the complaint allegation(s) were Unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.
No deficiencies cited.
Exit interview was conducted with Janine Sorenson, Lead Caregiver.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Dina Alviso
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
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 1