Complaint Investigation Report

125000592-9-9-2025-21-AS-BMOS-DLLNK5-20250917103122

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SANTA ROSA RO , 1450 NEOTOMAS AVENUE, STE. 100

This is an official report of an unannounced visit/investigation of a complaint received in our office on

06/12/2025 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20250612142910

Facility failed to arrange for medical care

At approximately 1:00PM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to conduct an investigation into the above allegation. LPA met with Administrator Larona Farnum and reviewed records. Based on records reviewed and interviews conducted, Resident, R1, was at a scheduled medical visit when they were informed the physician was out unexpectedly. The physician office staff suggested R1 be seen at the emergency room, ER, or return later to the Urgent Care. Due to lack of available staff and wait times in the ER, facility staff did not take R1 to ER and returned later with R1 to be seen at the Urgent Care. Urgent care staff told R1's escort there were too many people waiting to be seen and they would not be able to see R1 that day. Licensee contacted Hospice the following day for a consult and R1 was admitted to Hospice.

Although the allegation 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 allegation is Unsubstantiated.