216804066-2-19-2026-21-AS-KMOA-DRNSKS-20260226125714

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 216804066
Report Date: 02/19/2026
Date Signed: 02/19/2026 02:17:13 PM

Unsubstantiated

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
01/09/2026 and conducted by Evaluator Anthony Loera

COMPLAINT CONTROL NUMBER: 21-AS-20260109122431

FACILITY NAME:	BLUFFS AT HAMILTON HILL, THE		FACILITY NUMBER:	216804066
ADMINISTRATOR:	RIVERA, MELON		FACILITY TYPE:	740
ADDRESS:	1 HAMILTON HILL DRIVE		TELEPHONE:	(415) 889-8026
CITY:	NOVATO	STATE: CA	ZIP CODE:	94949
CAPACITY:	95	CENSUS: 85	DATE:	02/19/2026
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Executive Director, Melon Rivera		TIME COMPLETED:	02:35 PM

ALLEGATION(S):

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Staff did not meet a resident's incontinence needs
Staff allowed a resident to be soiled
Staff did not meet a resident's laundry needs

INVESTIGATION FINDINGS:

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On 02/19/2026, Licensing Program Analyst (LPA) Loera conducted an unannounced visit for the purpose of delivering complaint findings. LPA arrived and met with Executive Director, Melon Rivera. During the course of the investigation, LPA reviewed records, conducted interviews, and made observations.

Compliant alleges, staff did not meet a resident's incontinence needs, staff allowed a resident to be soiled, and staff did not meet a resident's laundry needs.

Based upon department record review, observations, and interviews conducted the following determination has been made. Complainant alleged staff did not meet a resident's incontinence needs. Complainant stated on 01/09/2026, resident (R1) was found saturated in urine. Review of R1s care summary, shows that R1 has incontinent bladder and requires assistance with frequent or unscheduled incontinence care. Interviews with two out of three staff revealed that R1 will try to use the bathroom on their own and once they have an accident, they will call for assistance. Interview with staff also reveal that since R1 has incontinence care, staff can check up on R1 and minutes later, R1 can have an accident.

continued on LIC9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Anthony Loera
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 21-AS-20260109122431

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: BLUFFS AT HAMILTON HILL, THE	FACILITY NUMBER: 216804066
	VISIT DATE: 02/19/2026

NARRATIVE

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Complainant alleged staff allowed a resident to be soiled on 01/09/2026. LPA was provided with documentation regarding the incident on 01/09/2026; showing that staff (S1) confirmed that incontinent care was provided to R1 twice during the shift with no concerns noted. Interview with witness revealed that they do not recall the incident happening on 01/09/2026 and R1 seems to do good with staff and has no concerns. Shift notes for AM shift (6:30AM - 2:30PM) 01/09/2026 show “good” for R1 with no additional notes provided.

Complainant alleged staff did not meet a resident's laundry needs as R1s laundry was full and most of R1s clothes were unwearable or soiled on 01/09/2026. LPA observed R1s room and found it to be clean and odor free. R1s closet was found to have clean dry clothing; ready to be worn. Interview with witness revealed they have no concerns regarding laundry needs.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Anthony Loera
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2026

LIC9099 (FAS) - (06/04)

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