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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 574500508
Report Date: 08/23/2023
Date Signed: 08/23/2023 01:41:41 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/15/2023 and conducted by Evaluator Lauren Scott
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20230815142340
FACILITY NAME:REICHENBACH, REBEKAHFACILITY NUMBER:
574500508
ADMINISTRATOR:REICHENBACH, REBEKAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 204-0254
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY:14CENSUS: 4DATE:
08/23/2023
UNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:licensee, Rebekah ReichenbachTIME COMPLETED:
01:50 PM
ALLEGATION(S):
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Licensee does not ensure facility is clean and orderly
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Lauren Scott and David Nguyen met with licensee, Rebekah Reichenbach regarding the above allegation.

During the course of the investigation, LPAs did a tour of the home, conducted interviews, and obtained information pertaining to allegation. It was alleged that the home was not clean or orderly. Through observations, LPAs determined some on limits areas were disorderly and unsanitary.

Based on the observations of the facility, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Title 22 regulations are being cited on the attached 9099-D page.

An exit interview was conducted with the licensee. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023
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 53-CC-20230815142340
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: REICHENBACH, REBEKAH
FACILITY NUMBER: 574500508
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/25/2023
Section Cited
CCR
102417(b)
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The home shall be kept clean and orderly, with heating and ventilation for safety and comfort.

This requirement was not as evidenced by:
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Licensee agrees to sanitizing and cleaning of the home. Licensee stated she will clean and oragnize the home. LPA requested back bedroom that leads to backyard and backyard will be off limits until LPA completes an addiitonal inspection to ensure cleaning was complete
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LPA’s observed the home environment to be unclean and disorderly which causes a potential health and safety risk to those in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3