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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496804032
Report Date: 02/07/2025
Date Signed: 02/07/2025 03:34:31 PM

Document Has Been Signed on 02/07/2025 03:34 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:COGIR OF SONOMA PLAZAFACILITY NUMBER:
496804032
ADMINISTRATOR/
DIRECTOR:		CORNEJO, WENDYFACILITY TYPE:
740
ADDRESS:91 NAPA ROADTELEPHONE:
(707) 939-1500
CITY:SONOMASTATE: CAZIP CODE:
95476
CAPACITY: 105CENSUS: DATE:
02/07/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Administrator Wendy CornejoTIME VISIT/
INSPECTION COMPLETED:
03:47 PM
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Licensing Program Analysts (LPAs) Christi Coppo and Elias Magdaleno arrived unannounced to conduct a required Annual inspection and was greeted by Administrator Wendy Cornejo. Facility contact information was reviewed.

At approximately 10:30am LPAs and Admin toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPAs observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered. LPAs reviewed temperature logs of refrigerator and freezer, temperatures documented within regulation. Kitchen water temperature measured at 130.2 degrees F, hot water sign present above one sink. Facility staff immediately added caution signs above all other kitchen sinks. First aid kits present and fully stocked.

LPAs toured selected rooms in assisted living and memory care. LPAs observed pull cords and grab bars present in all rooms. All bedrooms were clean and in good repair. Water temperature measured 109.2 degrees F in room 108, 109.8 degrees F in room 126, and 109.4 degrees F in resident accessible memory care kitchen, which is within the allowable range of 105 to 120 degrees F.

Fire extinguishers were last inspected 12/30/2024. Smoke/Carbon Monoxide detectors, sprinklers located throughout the facility are hardwired and serviced by a vendor, last date of service 12/20/2024. Facility’s last quarterly disaster drill was conducted on 11/20/2024. LPAs and Admin discussed conducting emergency drills every quarter. Facility has a backup generator for use during a power outage.



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SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Christi Coppo
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: COGIR OF SONOMA PLAZA
FACILITY NUMBER: 496804032
VISIT DATE: 02/07/2025
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At approximately 12:45pm LPAs conducted a review of six (6) resident records. All required documentation present.



At approximately 1:30pm LPAs conducted review of six (6) staff records. All required documentation present.

At approximately 3:00pm LPAs and Health and Wellness Director conducted a spot check of medication and medication records. Medication is centrally stored in locked medcarts. No deficiencies

Wendy Cornejo Administrator Certificate 7005339740 expires 7/22/2026. All fees are current as of this time.



LPA and Administrator discussed facility's Infection Control Plan and Emergency Disaster plan. No new updates.

Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: Liability Insurance

No deficiencies cited. Exit interview conducted with Administrator and a copy of this report was given.

SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Christi Coppo
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025
LIC809 (FAS) - (06/04)
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