<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486804008
Report Date: 07/25/2025
Date Signed: 07/25/2025 11:42:43 AM

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
05/22/2025 and conducted by Evaluator Elias Magdaleno
COMPLAINT CONTROL NUMBER: 21-AS-20250522104738
FACILITY NAME:ALF SANCTUARY ADULT RESIDENTIAL CAREFACILITY NUMBER:
486804008
ADMINISTRATOR:MARIA BUNAFACILITY TYPE:
740
ADDRESS:521 SARAH WAYTELEPHONE:
(707) 759-5392
CITY:SUISUN CITYSTATE: CAZIP CODE:
94585
CAPACITY:6CENSUS: 5DATE:
07/25/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Maria Buna, AdministratorTIME COMPLETED:
10:45 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Admission agreement did not reflect charging resident for Hospice care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Magdaleno arrived unannounced for the purpose of delivering findings on the above complaint allegations and met with Maria Buna, Administrator.

During this investigation LPA made observations, reviewed records, and conducted interviews.

Admission agreement did not reflect charging resident for Hospice care – Complaint alleges that the facility has imposed a change of condition fee and hospice care fee totaling $1,000 but the fees were not a listed or mentioned in the Admission Agreement. Review of letter titled “Notice Letter for Rate Change Due to New Level of Care" indicates that per page 6 of the Admission Agreement that states “You and/or your responsible party will be given a 60-day written notice of any increase to your Basic Services rate. This written notice will include the amount of the increase, the reason for the increase, and a general description of the additional costs.
Continued LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Elias Magdaleno
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2025
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-20250522104738
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: ALF SANCTUARY ADULT RESIDENTIAL CARE
FACILITY NUMBER: 486804008
VISIT DATE: 07/25/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Continued from LIC9099...

This does not apply to additional services that are from a new level of care that we are required to provide to you to allow for your reasonable and appropriate level of care and supervision. If additional services are provided that arose from a new level of care, written notice will be provided to the resident and/or the resident's representative, if any, within two business days of providing the additional services that results in a rate increase. The notice will Include a detailed explanation of the additional services provided and must itemize the charges.” The letter indicates the additional charges for “Hospice Status” and “New level of care” and then lists the additional care needs. Licensee confirmed that hospice services are not considered an optional service but a necessary medical need. Based upon observations and interviews, we have found that 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/complaint is UNSUBSTANTIATED.

No deficiencies cited. Exit interview conducted with Administrator, whose signature on form confirms receipt.
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Elias Magdaleno
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2