Complaint Investigation Report

236803448-4-22-2025-21-AS-KMOA-DGASUV-20250502141145

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

03/04/2025 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20250304082417

Staff do not ensure facility has adequate staffing to meet resident's needs.

Staff do not ensure activities are provided to residents.

At approximately 8:00AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to conduct an investigation into the above allegations. LPA met with Executive Director Zenia Shah, interviewed staff and reviewed records. Based on interviews and records reviewed, facility has not had adequate staffing on a regular basis to meet residents needs. Records reviewed showed at least two individuals requiring 2 person assistance in the building. Staffing records show only one staff assigned to the memory care area. When staff are called from the assisted living portion of the building to assist in memory care, resident wait times are extended in the rest of the building. Based on observation, care staff are serving meals, which takes them off the floor to assist residents that did not come to the dining room. The activities program advertises weekly outings that are routinly cancelled due to staffing concerns. LPA reviewed the activity calendar designed for memory care and observed the activities do not occur on a regular basis. During this visit, 2 of the listed activities for the memory care area did not occur.

Based on the Departments investigation, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

This report was reviewed with Zenia Shah and Appeal rights were given.