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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 286803879
Report Date: 09/25/2025
Date Signed: 09/25/2025 04:18:13 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
06/10/2025 and conducted by Evaluator Julie Florio
COMPLAINT CONTROL NUMBER: 21-AS-20250610133209
FACILITY NAME:ASSISTED LIVING OF NAPA VALLEY-SHERMANFACILITY NUMBER:
286803879
ADMINISTRATOR:ARNKE, CHRISTINEFACILITY TYPE:
740
ADDRESS:1460 SHERMAN AVETELEPHONE:
(707) 312-2971
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY:6CENSUS: 6DATE:
09/25/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Christine Arnke, AdministratorTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Not Meeting Residents’ Care Needs
Insufficient Staffing
Staff Training
INVESTIGATION FINDINGS:
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On 09/25/2025, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to deliver complaint #21-AS-20250610133209 investigation findings regarding the above allegations and met with Christine Arnke, Administrator. Reporting Party (RP) alleges that the facility is not meeting residents’ care needs, there is insufficient staffing, and staff are not properly trained.

LPA Florio conducted 10-day complaint investigation visit on 06/17/2025 and obtained documents, made observations, and conducted interviews. During this visit, it was revealed through an interview with Licensee and the facility's LIC500 Personnel Report that facility is sufficiently staffed, with two (2) care staff and the administrator present M-F and every other Saturday during daytime hours; two (2) care staff every Sunday and every other Saturday during daytime hours; and one awake, non-live in care staff every night, Monday through Sunday.

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

DATE: 09/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
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-20250610133209
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: ASSISTED LIVING OF NAPA VALLEY-SHERMAN
FACILITY NUMBER: 286803879
VISIT DATE: 09/25/2025
NARRATIVE
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Continued from LIC9099...

On 06/10/2025, LPA received a string of email communications between Licensee and R1's responsible party and a 30-day eviction notice both detailing the increased care needs of R1 requiring 1:1 care that the facility was unable to provide without additional staffing. The facility offered R1's responsible party the option to hire a 1:1 caregiver or relocate the resident in these communications. On 09/25/2025, LPA obtained copies of R1's third party care plans dated 01/03/2025 and 06/9/2025; R1's LIC602 physician's report dated 10/20/2024; R1's Pre-Placement Appraisal dated 10/23/2025; and R1's re-appraisal dated 06/06/2025. These documents revealed an increase in R1's care needs requiring a hirer level of care from when R1 first moved into the facility 10/2024. On 06/17/2025 R1 was relocated to a new care facility.

On 09/23/2025 LPA received copies of additional email and text communication between R1's responsible party and the Licensee discussing an incident that occurred on 06/04/2025 where R1's responsible party expressed staff training concerns due to their witnessed response of care staff to an emergency situation. On 09/25/2025, LPA obtained copies of S1 and S2's current first aid and CPR certifications, staff hoyer lift training, and observed all the required training documented in S1 and S2's personnel files. Based on observations made, interviews conducted, and records reviewed, the department received conflicting information.

Based on interviews conducted and records obtained, the allegations the facility is not meeting residents’ care needs, there is insufficient staffing, and staff are not properly trained are 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 allegations are UNSUBSTANTIATED.

No deficiencies cited.

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

DATE: 09/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2