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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 176803831
Report Date: 01/31/2025
Date Signed: 01/31/2025 11:52:03 AM

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
11/15/2024 and conducted by Evaluator Christopher Arnhold
COMPLAINT CONTROL NUMBER: 21-AS-20241115151846
FACILITY NAME:ORCHARD PARK SENIOR LIVING COMMUNITYFACILITY NUMBER:
176803831
ADMINISTRATOR:DANELLE SANTONIFACILITY TYPE:
740
ADDRESS:14789 BURNS VALLEY ROADTELEPHONE:
(707) 995-1900
CITY:CLEARLAKESTATE: CAZIP CODE:
95422
CAPACITY:56CENSUS: 33DATE:
01/31/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Melissa JonesTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff allow residents to be left in soiled clothing for an extended period of time
Staff do not ensure residents receive adequate food portions
Staff do not ensure residents are provided with snacks in between meals each day
Staff handle residents in a rough manner
INVESTIGATION FINDINGS:
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At approximately 9:00AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to conduct an investigation into the above allegations. LPA's met with Executive Director Melissa Jones, toured the building, reviewed records and interviewed staff and residents. Based on interviews conducted, LPA did not find evidence to support the allegation that Staff allow residents to be left in soiled clothing for an extended period of time. Facility staff conduct checks at least every 2 hours on each resident in the facility. Residents needing more assistance receive it more frequently. LPA was informed most residents are able to communicate their needs and are not shy about letting staff know. Those residents that are not able to communicate their needs are checked on more frequently. Based on interviews conducted, LPA did not find evidence to support the allegation that Staff do not ensure residents receive adequate food portions and Staff do not ensure residents are provided with snacks in between meals each day. Residents receive the amount of food they request. If they want more food when they are finished, they ask staff and more food is delivered. There are snacks provided in the activity room along with several fruit bowls in the common areas. In the afternoons a hydration cart travels through the facility with cookies, fruit and drinks.
Continued on LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025
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-20241115151846
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: ORCHARD PARK SENIOR LIVING COMMUNITY
FACILITY NUMBER: 176803831
VISIT DATE: 01/31/2025
NARRATIVE
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 Based on interviews conducted, LPA did not find evidence to support the allegation that Staff handle residents in a rough manner. Staff interviewed reported that residents are very vocal and would alert other staff if they were handled in a rough manner by any staff.

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: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2