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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 286801070
Report Date: 01/30/2026
Date Signed: 02/05/2026 12:02:53 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
10/24/2025 and conducted by Evaluator Julie Florio
COMPLAINT CONTROL NUMBER: 21-AS-20251024124228
FACILITY NAME:MEADOWS OF NAPA VALLEY, THEFACILITY NUMBER:
286801070
ADMINISTRATOR:KRISTINE MORROWFACILITY TYPE:
741
ADDRESS:1800 ATRIUM PARKWAYTELEPHONE:
(707) 257-7885
CITY:NAPASTATE: CAZIP CODE:
94559
CAPACITY:350CENSUS: DATE:
01/30/2026
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Kristine Morrow, Executive DirectorTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Neglect resulted in resident sustaining an injury causing death
INVESTIGATION FINDINGS:
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On 01/30/2026, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to deliver complaint #21-AS-20251024124228 investigation findings and met with Kristine Morrow, Executive Director. Reporting Party (RP) alleges neglect resulted in resident sustaining an injury causing death.

LPA Florio conducted 10-day complaint investigation visit on 10/27/2025 and obtained documents. Resident 1 (R1) experienced a witnessed fall on 10/16/2025. Facility staff were unable to prevent R1 from falling and appropriately activated Emergency Medical Services (EMS). R1 denied being in pain and initially refused to be treated at the hospital when Emergency Medical Responders (EMR) evaluated them. R1 was transported to the hospital; they passed away on 10/17/2025. A local Coroner’s Office conducted an investigation and determined that R1’s immediate cause of death was brain death, intracranial hemorrhage, and traumatic injury of head as a result of an accidental ground level fall.

Continued on LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Julie Florio
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2026
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 2
Control Number 21-AS-20251024124228
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: MEADOWS OF NAPA VALLEY, THE
FACILITY NUMBER: 286801070
VISIT DATE: 01/30/2026
NARRATIVE
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Continued from LIC9099...

Based on observations made, interviews conducted, and records reviewed, the Department received conflicting information regarding the above allegation.

Based on interviews conducted, observations made, and records obtained, the allegation that neglect resulted in resident sustaining an injury causing death is UNSUBSTANTIATED. A finding that a complaint allegation is unsubstantiated means that although the allegation 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.

No deficiencies cited.

Exit interview conducted with Executive Director, whose signature on form confirms receipt of document(s).
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Julie Florio
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2