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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486803806
Report Date: 05/15/2025
Date Signed: 05/15/2025 02:13:03 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
02/10/2025 and conducted by Evaluator Shannan Hansen
COMPLAINT CONTROL NUMBER: 21-AS-20250210131006
FACILITY NAME:VILLAGE AT RANCHO SOLANO ASSISTED LIVING, THEFACILITY NUMBER:
486803806
ADMINISTRATOR:WHINERY,MORGANFACILITY TYPE:
740
ADDRESS:3350 CHERRY HILLS COURTTELEPHONE:
(707) 425-3588
CITY:FAIRFIELDSTATE: CAZIP CODE:
94534
CAPACITY:250CENSUS: 171DATE:
05/15/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Morgan Whinery, AdministratorTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff are not following resident's care plan
Staff is not ensuring residents' personal rights
INVESTIGATION FINDINGS:
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On 5/15/2025, Licnesing Program Analyst (LPA) Shannan Hansen arrived unannounced to deliver complaint investigation findings regarding the above alligation and met with Morgan Whinery, Administrator.

Staff are not following resident care plan- Reporting party alleges facility raised the level of care rate because they said the resident needed 2 staff members to help with ADL but reporting party indicates resident usually only gets help from 1 staff member. During the investigation process LPA conducted 3 visits (2/20/2025-3/6/2025, & 5/15/2025), staff interviews, and obtained resident's Care Notes, Physician's Report, Care conference documents, and Service Plan. Resident resides in memory care unit. Interviews and documents revealed resident (R1) was admitted to facility 10/2024 and was increasted one level in 12/2024 due to becoming combative when staff were providing care and with insuline management. First episode was shortly after moving in. LPA was unable to obtain evidence that a violation occured. Unsubstantiated.

Continue on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Shannan Hansen
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2025
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-20250210131006
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: VILLAGE AT RANCHO SOLANO ASSISTED LIVING, THE
FACILITY NUMBER: 486803806
VISIT DATE: 05/15/2025
NARRATIVE
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Continued from LIC9099

Staff is not ensuring residents' personal rights- reporting party alleges there is a resident that wanders and has wandered into this resident's room at 3AM and climbed into bed with them making them very scared, aggressive and upset. Interviews conducted with staff and Administrator revealed in November 2024 facility began to allow resident who could manage a key to lock their doors in memory care. R1 is able to use and keep their own key. There has not been any incidences since the keys have been implemented. LPA was unable to obtain evidence that a violation occurred.

Based on interviews, record/document reviews, and related information obtained during the investigation the allegations Staff are not following resident's care plan and Staff is not ensuring residents' personal rights UNSUBSTANTIATED

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore, the allegations are UNSUBSTANTIATED.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Shannan Hansen
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2