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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486803806
Report Date: 03/18/2025
Date Signed: 03/18/2025 10:50:29 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
02/21/2025 and conducted by Evaluator David Leibert
COMPLAINT CONTROL NUMBER: 21-AS-20250221094940
FACILITY NAME:VILLAGE AT RANCHO SOLANO ASSISTED LIVING, THEFACILITY NUMBER:
486803806
ADMINISTRATOR:WHINERY,MORGANFACILITY TYPE:
740
ADDRESS:3350 CHERRY HILLS COURTTELEPHONE:
(707) 425-3588
CITY:FAIRFIELDSTATE: CAZIP CODE:
94534
CAPACITY:250CENSUS: 159DATE:
03/18/2025
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Morgan WhineryTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Personal Rights
INVESTIGATION FINDINGS:
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Licensing Program Analyst Leibert arrived unannounced for the purpose of delivering findings on this complaint. This investigation consisted of a review of documents, site visits to the facility and statements from witnesses and the parties. The following determinations are made: Resident (R1) resides in the facility's memory care unit and shares a room with another Resident (R2); Family members of R1 express concerns that R2 has entered R1's area on many occasions resulting in R1's personal rights being compromised; Facility staff have made hourly wellness checks on R1 in an attempt to prevent R2 from entering R1's area uninvited; Family members have provided videos taken on 2/21/2025 and 3/7/2025 which depict R2 entering the bed of R1 while the bed is occupied by R1 and one depicting R2 entering the bed of R1 which is unoccupied after R2 has removed R2's pants, exposing R2's buttocks. Based upon the videos and statements, there is a preponderance of evidence to prove that the allegation of a personal rights violation has been SUBSTANTIATED and is valid. The following deficiencies were observed (see LIC 9099D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Rights provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carla Martinez
LICENSING EVALUATOR NAME: David Leibert
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2025
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-20250221094940
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: VILLAGE AT RANCHO SOLANO ASSISTED LIVING, THE
FACILITY NUMBER: 486803806
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/20/2025
Section Cited
CCR
87468.1(a)(3)
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87468.1(a)(3) Personal Rights of...Residents…all residents…shall have personal rights to be free from …interfering with daily living functions such as…sleeping… *** Based on statements and videos, this requirement has not been met as evidenced by: Resident R2
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Administration will provide a written plan to CCL by POc date that outlines how the facility will protect R1 from further personal rights violations.
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has repeatedly ventured into Resident R1’s space and handled R1’s belongings and is seen on video taken on 2/21/25 entering R1’s bed while an apparent sleeping R1 is occupying the bed. This posed an immediate violation of R1’s personal rights.
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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: Carla Martinez
LICENSING EVALUATOR NAME: David Leibert
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2025
LIC9099 (FAS) - (06/04)
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