<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486803710
Report Date: 12/16/2025
Date Signed: 12/16/2025 11:08:04 AM

Substantiated


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
10/27/2025 and conducted by Evaluator Star Stevenson
COMPLAINT CONTROL NUMBER: 21-AS-20251027095406
FACILITY NAME:PARAMOUNT HOUSE SENIOR LIVINGFACILITY NUMBER:
486803710
ADMINISTRATOR:SAMANIEGO,AGUSTINFACILITY TYPE:
740
ADDRESS:2061 PEABODY RDTELEPHONE:
(707) 455-0300
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY:95CENSUS: 80DATE:
12/16/2025
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Elizabeth Aguiar - Resident Service DirectorTIME COMPLETED:
11:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Reporting requirements
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 12/16/2025 Licensing Program Analyst (LPA) Stevenson arrived unannounced to conduct a complaint investigation and delivered findings regarding the allegation listed above and met with Elizabeth Aguiar - Resident Service Director.

Compliant alleges that management staff were made aware of suspected theft of resident’s (R1) coins and snacks, but that management, "did nothing anything about it". Based on confidential interviews conducted by LPA with complainant and three (3) staff (S2, S3 & S4) and nine (9) residents (R1-R9). During the course of the investigation, LPA learned that R1 had made their suspicions of theft known on at least two occasions with complainant indicating R1's concerns of theft were brought up to staff on 08/12/2025 and again on 10/12/2025. Based on records review, LPA obtained copies of charting notes dated 10/14/2025 that indicated R1 "was mad because they caught staff member (S1) stealing from R1's room again. R1 said this isn't the first time that the catch staff member stealing from their room". According to interviews conducted by LPA with R1, it revealed that they suspected snacks and coins had been taken from their room by S1.

Continued on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Star Stevenson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
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 5
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
10/27/2025 and conducted by Evaluator Star Stevenson
COMPLAINT CONTROL NUMBER: 21-AS-20251027095406

FACILITY NAME:PARAMOUNT HOUSE SENIOR LIVINGFACILITY NUMBER:
486803710
ADMINISTRATOR:SAMANIEGO,AGUSTINFACILITY TYPE:
740
ADDRESS:2061 PEABODY RDTELEPHONE:
(707) 455-0300
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY:95CENSUS: 80DATE:
12/16/2025
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Elizabeth Aguiar - Resident Service Director TIME COMPLETED:
11:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Financial Abuse
Personal Rights
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 12/16/2025 Licensing Program Analyst (LPA) Stevenson arrived unannounced to conduct a complaint investigation and delivered findings regarding the allegation listed above and met with Elizabeth Aguiar - Resident Service Director.

The complaint allegations were that of financial abuse of a resident and violation of personal rights. Per Reporting party, on 10/24/2025 there was a concern raised by resident (R1) regarding financial abuse from staff (S1) who allegedly had taken money/"change" and food from their room. Complainant states that staff (S2) had raised the concern to management, but it is unclear if any investigation or corrective action appears to have been taken by management at Paramount House Senior Living. During the course of the investigation, the Department requested and reviewed documents, conducted interviews, and made observations. Based on records review, LPA learned that R1 has a medical history of Mild Cognitive Impairment (MCI) indicating memory or thinking problems that could be more impaired than a resident of similar age, in addition through interview with R1 and S1, LPA learned that R1 has a history of offering snacks with staff and did not keep an inventory of their snacks or coins.

Continued on LIC9099-D
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Star Stevenson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 21-AS-20251027095406
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: PARAMOUNT HOUSE SENIOR LIVING
FACILITY NUMBER: 486803710
VISIT DATE: 12/16/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Continued from LIC9099

In addition, LPA learned from R1 and S1 that R1 had asked for S1's help in determining the value of the various coins they kept in their apartment

Interviews with seven (7) other residents (R3, R4, R5, R6, R7, R8 and R9), most in the same hall as R1 revealed no concerns for theft or ongoing thefts,  including that of small snacks. Because of the lack of hard proof of theft of snack or coins, R1's medical history of MCI and because of R1's admission that no unusual incidents have occurred since the licensee performed an Internal Investigation and set a plan to avoid potential theft from or allegation of theft by R1, the allegation is Unsubstantiated.
 
A finding that the complaint 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.
 
This report was reviewed with Resident Service Director - Elizabeth Aguiar.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Star Stevenson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 21-AS-20251027095406
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: PARAMOUNT HOUSE SENIOR LIVING
FACILITY NUMBER: 486803710
VISIT DATE: 12/16/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Continued for LIC9099

In addition, document review also confirmed that an "Internal Incident Report" had been generated by the management at Paramount on 10/22/2025 over the possible theft from R1 and that S1 was advised not to help R1 without another caregiver present. Because management was made aware R1's concern for theft from their room on at least two occasions and Community Care Licensing never received an Unusual Incident Report from the facility about the R1's concern from theft, the allegation is Substantiated.  A finding that the complaint is substantiated means there is a preponderance of evidence to prove the alleged violation did occur.
 
A deficiency is being issued for violation of California Code of Regulations (CCR) 87211(a)(1)(D) , which requires, licensing to be given an Unusual Incident Report within seven days...any incident which threatens the welfare, safety or health of any resident...
 
Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Report was reviewed with Elizabeth Aguiar - Resident Service Director, whose signature here confirms receipt.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Star Stevenson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 21-AS-20251027095406
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: PARAMOUNT HOUSE SENIOR LIVING
FACILITY NUMBER: 486803710
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/16/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/30/2025
Section Cited
CCR
87211(a)(1)(D)
1
2
3
4
5
6
7
87211 Reporting Requirements
(a) Each licensee shall furnish to licensing...a written report...within 7 days...any incident which threatens the welfare, safety, or health of any resident...

1
2
3
4
5
6
7
Licensee to submit self-certification that they have reviewed all Reporting Requirements 87211 with management staff and submit self-certification to licensing by 12/30/2025
8
9
10
11
12
13
14
This requirement was not met by evidence by:
Based on interview and record review, the licensee did not comply in 1 out of 1 instance which poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Star Stevenson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5