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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486803645
Report Date: 02/20/2025
Date Signed: 02/20/2025 04:09:45 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
02/11/2025 and conducted by Evaluator Caitlynn Felias
COMPLAINT CONTROL NUMBER: 21-AS-20250211151605
FACILITY NAME:VACAVILLE MEMORY CAREFACILITY NUMBER:
486803645
ADMINISTRATOR:MCGRANAHAN, JULIETFACILITY TYPE:
740
ADDRESS:431 NUT TREE ROADTELEPHONE:
(707) 449-1350
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY:75CENSUS: 63DATE:
02/20/2025
UNANNOUNCEDTIME BEGAN:
11:21 AM
MET WITH:Executive Director, Juliet McGranahanTIME COMPLETED:
04:20 PM
ALLEGATION(S):
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An adult at the facility is forcing a resident to eat
INVESTIGATION FINDINGS:
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At approximately 11:10AM, Licensing Program Analyst (LPA) Felias arrived unannounced to initiate a Complaint Investigation regarding the above allegation and met with Executive Director, Juliet McGranahan.

During the investigation, the Department requested and reviewed documents, conducted interviews, and made observations. The following allegation was investigated, "An adult at the facility is forcing a resident to eat.” Report received on 02/11/2025 alleged that an adult at the facility is forcing a resident to eat. Report received also included a photograph that showed an female individual dressed in scrubs. The individual was shown to be holding a piece of food on a fork and was being held in front of a female resident's mouth. Per photograph, it does not appear that the resident is in distress. LPA was unable to receive additional details about the photograph provided such as date, time of day, or resident's name. Based on interviews, LPA identified that there are residents at the facility who require assistance with eating/feeding.

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

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
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-20250211151605
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: VACAVILLE MEMORY CARE
FACILITY NUMBER: 486803645
VISIT DATE: 02/20/2025
NARRATIVE
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Continued from LIC9099

LPA was informed that facility staff will help residents eat through verbal prompting or by guiding the utensil to a resident's mouth. Per interviews, there are 4 residents that require help with feeding. Review of resident files indicated that none of these residents were the resident shown in the photograph. Interviews conducted also indicated that they have not observed residents to be force fed by staff. During visit conducted on 02/20/2025, LPA observed lunch being served to the residents. LPA observed that some residents were being verbally prompted to eat. LPA did not observe any resident being hand-fed but was informed that some of the residents were sleeping and would be provided their meal when they woke up.

Based on document review, interviews conducted, and observations made, this allegation is Unsubstantiated. A finding that the complaint allegation is Unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

No Deficiencies Cited during visit.

Exit interview conducted. Copy of report discussed and provided to Executive Director/Administrator. Signature on form confirms receipt of documents.
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Caitlynn Felias
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2