Complaint Investigation Report

496804150-3-13-2026-21-AS-KMOA-DSCNVF-20260320104749

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

02/20/2026 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20260220132139

Staff did not provide resident with reappraisal

At approximately 8:45AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to conduct an investigation into the above allegation. LPA met with Resident Care Director Alicia Dixon, reviewed records and interviewed staff. Based on a review of documents and interviews conducted, LPA found the faciltiy did not provide resident with a reappraisal or provide residents responsible party written notification within two days of increasing residents care costs. Facility implemented a one on one caregiver on 12/05/2025, and conducted a meeting with responsible party on 12/9/2025. There was no documented evidence of this meeting until 01/29/2026. On 01/29/2026, a care conference was conducted with responsible party and an updated appraisal was provided. Documentation for that meeting referenced the meeting on 12/09/2025. Facility increased R1's care services but did not provide responsible party with written notification, to include the itemized cost of care, within two days.

Based on the Departments investigation, the preponderance of evidence standard has been met, therefore the above allegation is 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 Alicia Dixon and Appeal rights were given.