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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 286804041
Report Date: 04/21/2026
Date Signed: 04/21/2026 03:52:38 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
01/23/2026 and conducted by Evaluator Julie Florio
COMPLAINT CONTROL NUMBER: 21-AS-20260123104046
FACILITY NAME:NAPA VALLEY SENIOR CAREFACILITY NUMBER:
286804041
ADMINISTRATOR:MINERVA VILLEGASFACILITY TYPE:
740
ADDRESS:2465 REDWOOD ROADTELEPHONE:
(707) 258-8300
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY:46CENSUS: 25DATE:
04/21/2026
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Minerva Villegas, AdministratorTIME COMPLETED:
04:10 PM
ALLEGATION(S):
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Personal Rights
INVESTIGATION FINDINGS:
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On 04/21/2026, at approximately 12:15 PM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conclude investigation and deliver findings regarding LIC802 - Complaint Report 21-AS-20260123104046, which was received by Community Care Licensing (CCL) on 01/23/2026. Reporting Party (RP) alleges a personal rights violation. LPA met with Minerva Villegas, Administrator.

On 01/23/2026, during visit, LPA conducted an interview with Resident 1 (R1) where R1 stated they are well taken care of, have no complaints and do not have concerns that they are being over medicated. R1 appeared clean, calm, and comfortable. During this same visit, LPA obtained a copy of R1's LIC602A Physician's Report dated 11/19/2025 which indicates a dementia diagnonsis with "behavioral manifestations," medication to address these behaviors and direction that R1 is unable to manage their own medications.

Continued on LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Julie Florio
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2026
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-20260123104046
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: NAPA VALLEY SENIOR CARE
FACILITY NUMBER: 286804041
VISIT DATE: 04/21/2026
NARRATIVE
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Continued from LIC9099...

LPA also obtained a copy of R1's hospital discharge summary dated 11/19/2025 which indicates that R1 was assigned a public guardian, placed under a county conservatorship and was discharged to the facility under the care of a third party Hospice agency.

Today, LPA obtained a copy of R1's medication administration records dated 11/19/2025 through current, which indicate that R1's medications are administrated in compliance with R1's physician's orders. Based on the information obtained, LPA received conflicting information.

Based on interviews conducted, observations made, and records obtained, the allegation of a personal rights violation is UNSUBSTANTIATED. A finding that a complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies cited.

Exit interview conducted with Administrator, whose signature on form confirms receipt of document(s).
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Julie Florio
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2