Senior Care Records.

Facility Evaluation Report

Mirabel Lodge, Forestville02/04/2026Licence 496804122

Capacity34
Date signed02/04/2026 12:43:42 PM
Name of licensing program analystChristi Coppo
Name of licensing program managerVictoria Bertozzi
The inspector’s account

A non-compliance conference was conducted today in the Santa Rosa Regional Office to address issues concerning non--compliance . Present in the meeting were Licensing Regional Manager Carla Nuti-Martinez, Licensing Program Manager Victoria Bertozzi, and Licensing Program Analyst Christi Coppo, Licensee, Alex Varshavsky.

This meeting is being conducted to discuss concerns identified by the Licensing Department regarding the operation of this facility including but not limited to: Complaint investigation that has been substantiated for not providing timely medical attention and other concerns that have been addressed in case management: visits such as reporting requirements and staff communication with licensing.

- Timely Medical Attention: Facility failed to seek timely medical attention for residents in at least four [4] known cases.

- Documentation: Facility did not ensure that observations of residents' condition and care are documented.

- Communication with Licensing Department: Discussion around the regulatory allowance of CCL representatives to interview staff.

- Medication - Facility does not currently have a Medication Technician on all shifts and is leaving PRN medication pre-poured for the NOC shift.

CCL provided Administrator Qualifications and Duties and Basic Services to Licensee and provided information regarding the Technical Support Program.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction