496803639-7-15-2021-21-AS-HDBI-C543GR-20210719181446

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 496803639
Report Date: 07/15/2021
Date Signed: 07/15/2021 05:02:40 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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/24/2021 and conducted by Evaluator Farhaan Sarangi

COMPLAINT CONTROL NUMBER: 21-AS-20210624105326

FACILITY NAME:	PEOPLE'S CARE CHARMIAN		FACILITY NUMBER:	496803639
ADMINISTRATOR:	SEAWRIGHT, PATRICK		FACILITY TYPE:	740
ADDRESS:	5087 CHARMIAN DR		TELEPHONE:	(951) 775-7411
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95409
CAPACITY:	4	CENSUS: 4	DATE:	07/15/2021
		UNANNOUNCED	TIME BEGAN:	03:25 PM
MET WITH:	Direct Support Personnel (DSP), Danah Ficher		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Resident was sexually abused by staff

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Farhaan Sarangi conducted an unannounced complaint investigation for the purpose of delivering complaint findings. LPA met Direct Support Personnel (DSP), Danah Ficher, and was granted access into the facility.

LPA Sarangi initiated an investigation beginning on June 24, 2021 at approximately 03:29 PM. During the course of the investigation, LPA Sarangi interviewed staff, residents and various outside parties and agencies, including but not limited to responsible parties and witnesses. LPA reviewed client records and obtained a Santa Rosa Police Department Police Report.

Complaint alleges that clients (C1) Personal Rights were violated; LPA learned during the course of the investigation that C1 disclosed to his Primary Care Physician (PCP) that his Personal Rights were being violated. An Adult/Elder Abuse Report after the visit with R1s PCP was generated.

Report continued on LIC 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Hope DeBenedetti
LICENSING EVALUATOR NAME: Farhaan Sarangi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021

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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Control Number 21-AS-20210624105326

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: PEOPLE'S CARE CHARMIAN	FACILITY NUMBER: 496803639
	VISIT DATE: 07/15/2021

NARRATIVE

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Upon arrival back to the facility, Administrator was contacted in-person by a Law Enforcement officer utilizing proper identification. An investigation was conducted and based off statements made, and information that was received, the officer determined that the allegation made was false and inconsistent statements were provided by the R1 to the Law Enforcement officer.

LPA interviewed C1, C2, C3 and C4. During the confidential interview with C1, there was inconsistent statements made to LPA. In addition, C1 disclosed to the LPA that he didn’t like the previous Caregiver that was provided by the Regional Center. During this interview, LPA observed a new 1 on 1 Caregiver. LPA interviewed C2, C3 and C4 who reported no concerns at this time and observed to be content in placement. Based on interviews with staff and outside parties/agencies LPA learned that although 1 interviewee reported no concerns with the client and that client presents quietly. C1 is reported to have behavioral challenges. C1 has a history of previous known behaviors.

Based on the interviews that were conducted and the evidence reviewed, the allegation staff violating Personal Rights will be Unsubstantiated meaning that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegations are Unsubstantiated.

Exit interview was conducted and a copy of this report was signed by Direct Support Personnel (DSP), Danah Ficher, and emailed to the Facility Administrator, Patrick Seawright.

SUPERVISORS NAME: Hope DeBenedetti
LICENSING EVALUATOR NAME: Farhaan Sarangi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021

LIC9099 (FAS) - (06/04)

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