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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 286804053
Report Date: 06/25/2026
Date Signed: 06/25/2026 11:37:22 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
04/02/2026 and conducted by Evaluator Julie Florio
COMPLAINT CONTROL NUMBER: 21-AS-20260402105752
FACILITY NAME:NAPA VALLEY MEMORY CAREFACILITY NUMBER:
286804053
ADMINISTRATOR:RAGLAND, SHANTIFACILITY TYPE:
740
ADDRESS:903 SARATOGA DRIVETELEPHONE:
(707) 252-7488
CITY:NAPASTATE: CAZIP CODE:
94559
CAPACITY:44CENSUS: DATE:
06/25/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Minerva Villegas, Designated Responsible PartyTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff do not answer residents calls for assistance timely
INVESTIGATION FINDINGS:
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On 06/25/2026, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to obtain additional information, conclude complaint investigation, and deliver complaint #21-AS-20260402105752 investigation findings regarding the above allegation and met with Minerva Villegas, Designated Responsible Party.

On 04/02/2026, LPA initiated this complaint investigation and obtained documents, made observations, and conducted an interview. Based on staff schedules obtained for 03/2026 and 04/2026 and staff observed on site during the visit, the facility meets and/or exceeds the minimum required staffing of at least one awake staff member in each unit on all shifts.

Today, 06/25/2026, LPA returned to facility to conduct interviews, obtain additional documents, and make observations.

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

DATE: 06/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2026
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-20260402105752
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 MEMORY CARE
FACILITY NUMBER: 286804053
VISIT DATE: 06/25/2026
NARRATIVE
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Continued from LIC9099...

An interview with the Designated Responsible Party revealed that the facility has a centralized call system which can be activated by residents in their rooms and alerts care staff via a switchboard in the medication room that lights up to indicate which room and bed is calling for assistance and generates an audible sounds as well. However, the facility's call system does not track call response times. Further, LPA observed four staff in the common area assisting residents and two additional care staff rounding with peri care kits to assist residents with their activities of daily living upon arrival to the facility. Additionally, LPA was unable to obtain evidence that any adverse events have occurred as the result of the current staff to resident ratios. Based on interviews conducted, observations made, and documents obtained, LPA received conflicting information.

Based on interviews conducted, observations made, and records obtained, the allegation that staff do not answer residents calls for assistance timely 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 Designated Responsible Party, whose signature on form confirms receipt of document(s).
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Julie Florio
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2