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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 216803145
Report Date: 04/15/2026
Date Signed: 04/15/2026 09:49:12 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/29/2026 and conducted by Evaluator Caitlynn Felias
COMPLAINT CONTROL NUMBER: 21-AS-20260129164044
FACILITY NAME:GOLDEN HOME EXTENDED CARE, INC.FACILITY NUMBER:
216803145
ADMINISTRATOR:ZINGKHAI, RUFUSFACILITY TYPE:
740
ADDRESS:1234 LAS GALLINAS AVETELEPHONE:
(415) 479-6500
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY:28CENSUS: 19DATE:
04/15/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Staff Members, Shirik Sochanngan and Angel Socito, and Administrator, Rufus ZingkhaiTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Staff spoke inappropriately to resident in care
INVESTIGATION FINDINGS:
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At approximately 9:00AM, Licensing Program Analyst (LPA) Felias arrived unannounced to deliver findings for a complaint investigation regarding the above allegation, and met with Staff Members, Shirik Sochanngan, and Angel Socito. Administrator, Rufus Zingkhai arrived during visit at approximately 9:30AM.

During the investigation, the Department requested and reviewed documents, conducted interviews, and made observations. The following allegation was investigated, “Staff spoke inappropriately to resident in care.” Complaint alleged that Resident 1 (R1) had a conversation with Staff Member 1 (S1) about their cultural heritage where S1 asked R1, "what kind of food does a German person eat for breakfast, and what does a German person drink for breakfast?" R1 stated” Schwarez Brot,” or dark bread, and I don't know." Per complaint, S1 stated “Jews.” Per report, S1 did not apologize to R1 for their comments and R1 felt extremely offended.

Continued on LIC9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Caitlynn Felias
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 21-AS-20260129164044
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: GOLDEN HOME EXTENDED CARE, INC.
FACILITY NUMBER: 216803145
VISIT DATE: 04/15/2026
NARRATIVE
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Continued from LIC9099

LPA conducted interviews. Interview with Resident 1 (R1) stated that they had a conversation with S1. Per R1, the conversation was about their cultural heritage and was in a joking manner. In the interview, R1 stated that they were from Germany and that S1 asked them questions about what they ate and drank in Germany for breakfast. R1 stated that they answered that Germans eat “Schwarzbrot” or “dark bread” and that they did not know what Germans drank for breakfast. S1 then responded, “Yews,” in a joking manner. R1 stated that you had to listen hard to know if it was the drink “juice” or the race of people. R1 stated that they joked back with S1 and that they did not feel offended or disrespected by S1’s comments. R1 further stated that S1 apologized to them and they told S1 that there was no reason to apologize.

Interview conducted with Staff Member 1 (S1) stated that they spoke with R1 a lot. Per interview, they had a conversation with R1 about their cultures and they told R1 some jokes they had heard on Youtube. S1 stated that they heard later that their conversation had been reported and they were instructed to apologize to R1. Per S1, when they went to apologize, R1 was surprised and told them to forget about it and that it was nothing.

Based on interviews conducted, this allegation is Substantiated. A finding that the complaint allegation is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

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

Exit interview conducted. Copy of report, LIC9099D (Deficiency Page), Plan of Corrections, and Appeal Rights discussed and provided to Administrator. Signature on form confirms receipt of documents.

SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Caitlynn Felias
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 21-AS-20260129164044
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: GOLDEN HOME EXTENDED CARE, INC.
FACILITY NUMBER: 216803145
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/15/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/27/2026
Section Cited
CCR
87468.1(a)(1)
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87468.1 Personal Rights of Residents in All Facilities:(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by:
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Licensee to conduct inservice-training on Personal Rights and Cultural Competency. Training to include the following: Date, Topic, Name/Job Role, and Signatures. In-Service and supporting documents to be submitted to CCL for review and approval by POC due date of 04/27/2026.
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based on interviews conducted, Licensee did not comply with the section cited above and did not ensure R1’s personal rights. This poses a potential health, safety, and/or personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Caitlynn Felias
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3