486803645-1-3-2025-21-AS-VBEI-DCWUXA-20250114145802

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 486803645
Report Date: 01/03/2025
Date Signed: 01/03/2025 03:19:22 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
10/09/2024 and conducted by Evaluator Caitlynn Felias

COMPLAINT CONTROL NUMBER: 21-AS-20241009095052

FACILITY NAME:	PACIFICA SENIOR LIVING VACAVILLE		FACILITY NUMBER:	486803645
ADMINISTRATOR:	MCGRANAHAN, JULIET		FACILITY TYPE:	740
ADDRESS:	431 NUT TREE ROAD		TELEPHONE:	(707) 449-1350
CITY:	VACAVILLE	STATE: CA	ZIP CODE:	95687
CAPACITY:	75	CENSUS: 65	DATE:	01/03/2025
		UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Resident Care Director, Lorena Madrigal		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Personal Rights

INVESTIGATION FINDINGS:

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At approximately 9:35AM, Licensing Program Analyst (LPA) Felias arrived unannounced to continue a Complaint Investigation regarding the above allegation and met with Resident Care Director, Lorena Madrigal.

During the investigation, the Department conducted interviews. The following allegation was investigated, “Personal Rights." Report received on 10/09/2024 alleged that the Activities Director speaks Spanish to residents that do not understand Spanish and makes residents uncomfortable. Report stated that the Activities Director has been asked many times to not speak Spanish but continues to do so. LPA was unable to contact Complainant for additional information regarding allegation.

LPA conducted staff interviews. Interview with Executive Director revealed that the facility has Spanish and English-speaking residents. The facility employs facility staff who can speak English and Spanish in order to help residents feel comfortable and accomodate their care needs.
Continued on LIC9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Victoria Bertozzi	TELEPHONE: (707) 588-5059
LICENSING EVALUATOR NAME: Caitlynn Felias	TELEPHONE: 707-588-5039
LICENSING EVALUATOR SIGNATURE:	DATE: 01/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025

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 21-AS-20241009095052

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: PACIFICA SENIOR LIVING VACAVILLE	FACILITY NUMBER: 486803645
	VISIT DATE: 01/03/2025

NARRATIVE

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Continued from LIC9099

Interview conducted with Activities Director revealed that they speak both English and Spanish. When facilitating a group activity, they will address their audience in only English, as that is the main language the majority of their residents speak. Per Activities Director, they will speak Spanish to their Spanish-speaking residents, but in a large group setting, they will respond to questions in English.

Based on interviews conducted, this allegation is Unsubstantiated. A finding that the complaint allegation is Unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

No Deficiencies Cited during visit.

Exit interview conducted. Copy of report discussed and provided to Resident Care Director. Signature on form confirms receipt of documents.

SUPERVISOR'S NAME: Victoria Bertozzi	TELEPHONE: (707) 588-5059
LICENSING EVALUATOR NAME: Caitlynn Felias	TELEPHONE: 707-588-5039
LICENSING EVALUATOR SIGNATURE:	DATE: 01/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025

LIC9099 (FAS) - (06/04)

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