Facility Evaluation Report
At approximately 8:35AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Case Management - Incident visit, and met with Executive Director, AnneMarie Domizio. The purpose of the visit is to follow up on reports that were submitted to the Santa Rosa Regional Office (SRRO).
Incident Report 1: The SRRO received a report on 05/07/2026. Report stated that on 05/05/2026, Resident 1 (R1) was eating lunch when they began to exhibit signs of choking. Per report, staff were unsuccessful in dislodging the food particle and CPR was initiated and emergency services were contacted. R1 was transferred to the hospital. Facility made notifications per regulation.
Death Report: The SRRO received a death report on 05/08/2026. Report stated that on 05/07/2026, facility contacted the hospital for an update regarding R1. Facility was informed by the hospital that R1 passed away on 05/07/2026.
LPA conducted interviews and obtained additional documents.
Exit interview conducted. Copy of report discussed and provided to Executive Director. Signature on form confirms receipt of documents.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction