415600219-2-5-2026-14-AS-ACON-DRG2E8-20260219161932

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 415600219
Report Date: 02/05/2026
Date Signed: 02/05/2026 01:11:27 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/08/2025 and conducted by Evaluator Murial Han

PUBLIC

COMPLAINT CONTROL NUMBER: 14-AS-20251208115014

FACILITY NAME:	SONAS HOME		FACILITY NUMBER:	415600219
ADMINISTRATOR:	RYAN, EVELYN B.		FACILITY TYPE:	740
ADDRESS:	886 GULL AVENUE		TELEPHONE:	(650) 577-9909
CITY:	FOSTER CITY	STATE: CA	ZIP CODE:	94404
CAPACITY:	6	CENSUS: 4	DATE:	02/05/2026
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Administrator, Evelyn Ryan		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff inappropriately obtained confidential information regarding resident
Staff inappropriately made resident's POA pay for groceries
Staff are no ensuring resident gets exercise

INVESTIGATION FINDINGS:

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On February 5, 2026, Licensing Program Analyst (LPA) Murial Han conducted a visit to deliver the complaint investigation findings. LPA met with administrator, Evelyn Ryan and caregiver, Daisy Tubbs and LPA explained the purpose of today's visit.

Regarding allegation of staff inappropriately obtained confidential information regarding, the reporting party stated that the licensee went to R1’s skilled nursing facility and spoke to the nurse and had the nurse provide information pertaining to R1 without the responsible party's permission.

As part of the investigation, LPA interviewed the R1’s responsible party and the administrator/licensee.

According to R1’s responsible party, the administrator visited R1 at the skilled nursing facility on 11/29/2025 without their consent. The responsible party stated that prior to the visit, the licensee had already issued a 30-day eviction notice, therefore, the administrator was not authorized to visit R1 as the administrator/ licensee was no longer part of R1’s care team.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Murial Han
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 14-AS-20251208115014

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SONAS HOME	FACILITY NUMBER: 415600219
	VISIT DATE: 02/05/2026

NARRATIVE

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LPA interviewed the administrator/licensee who acknowledged that she did not obtain prior permission from R1’s responsible party to conduct an assessment of R1 at the Skilled Nursing Facility. However, the administrator/licensee stated the date of the visit was still within 30-day of the eviction notice. In addition, the administrator/licensee stated that she had provided proper introduction to the skilled nursing facility staff after she entered the facility, and she was provided with a name badge for the visit. Furthermore, She was given information by one of the Registered Nurses regarding R1’s care and she was allowed to physically assessed R1 in the room.

After the investigation, this allegation is deemed to be unsubstantiated as the date of the visit was still within the 30-day eviction notice and R1’s responsible party did not express to waive the 30-day eviction process. Therefore, based on R1’s admission agreement, R1 was still under the care of the facility.

Regarding the allegation of- Staff inappropriately made resident’s POA pay for groceries, the reporting party stated that R1 had a protein deficiency, so the doctor ordered more meat for R1. The reporting party stated that the facility staff brought more meat for R1 with their own money and asked R1’s responsible party for reimbursement.

As part of the investigation, LPA interviewed staff (S1) and the administrator/licensee.

LPA interviewed the administrator/licensee who denied the allegation and stated that the facility provided balanced meals for every resident but R1’s responsible party requested additional specific proteins such as organic yogurt, organic protein items and agreed to pay for it with R1’s income. However, R1’s income was delayed at the time, so the responsible party agreed to pay for it first.

According to S1, the facility was offering balanced meals to R1 as they followed a menus for breakfast, lunch and dinner but R1’s responsible party requested additional protein items such as yogurt, bacon, fish, etc and the responsible party consented to use R1’s money income to pay for it but R1’s income was delayed so R1’s responsible party agreed to pay for it first and reimburse the money back to S1.

SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Murial Han
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 14-AS-20251208115014

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SONAS HOME	FACILITY NUMBER: 415600219
	VISIT DATE: 02/05/2026

NARRATIVE

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Based on the written communication between the responsible party to the administrator/licensee, it indicated that the responsible party asked S1 to purchase additional proteins for R1 and agreed to pay S1 back with R1’s month income but the monthly income was delayed so the responsible party agreed to reimburse S1 first.

After the investigation, this allegation was deemed to be unsubstantiated.

Regarding the allegation of staff are not ensuring resident gets exercise, the reporting party stated that staff was not exercising R1 by taking R1 on walks.

As part of the investigation, LPA interviewed the administrator/licensee, and S1.

The administrator and S1 denied the allegation and both of them reported that R1 was walked outside when the weather permitted and around the house or in the backyard when the weather was bad. In addition, they stated that R1 was walked by therapists from the home health agency.

Based on the written communication from R1’s responsible party and the administrator/licensee dated May 20, 2025, it indicated that the responsible party was extremely pleased with R1’s placement and facility staff have been exceptionally helpful and welcoming of R1.

Based on R1’s annual face – to – face care team meeting reviewing R1’s overall stay at the facility, it indicated that R1 loved to go on walks with a staff.

After the investigation, this allegation is deemed to be unsubstantiated.

Although the above 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 allegation is UNSUBSTANTIATED.

This report is reviewed and discussed with the administrator and the caregiver. A copy is provided.

SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Murial Han
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2026

LIC9099 (FAS) - (06/04)

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