486803806-4-11-2023-21-AS-HDBI-CQTTWH-20230412150536

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 486803806
Report Date: 04/11/2023
Date Signed: 04/11/2023 09:49:32 AM

Unsubstantiated

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
02/14/2023 and conducted by Evaluator Farhaan Sarangi

COMPLAINT CONTROL NUMBER: 21-AS-20230214161618

FACILITY NAME:	VILLAGE AT RANCHO SOLANO ASSISTED LIVING, THE		FACILITY NUMBER:	486803806
ADMINISTRATOR:	RAMANDEEP KAUR		FACILITY TYPE:	740
ADDRESS:	3350 CHERRY HILLS COURT		TELEPHONE:	(707) 425-3588
CITY:	FAIRFIELD	STATE: CA	ZIP CODE:	94534
CAPACITY:	250	CENSUS: 154	DATE:	04/11/2023
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Assistant Executive Director, Francine Taitano		TIME COMPLETED:	09:45 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Food Service
Personal Rights
Physical Plant issue-No heat in room and kitchen sink is leaking

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced at Village at Rancho Solano, The for the purpose of delivering complaint findings. LPA was greeted at the door by Assistant Executive Director, Francine Taitano, and was granted access into the facility. Also participating in the delivery of findings is Executive Director, Brittany Andrews from a sister community.

During the course of the investigation, LPA Sarangi reviewed resident(s) records, staff records, facility records, interviewed staff, residents and various outside parties, including but not limited to responsible parties and witnesses.

Complaint alleges food service. Based on interviews that were conducted, LPA learned that the facility cooks food daily, and serves three meals to residents in placement. However, residents can have the choice to eat or not eat during servings of food. Facility does offer alternatives when asked and offers snacks. (Report continued on LIC 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Hope DeBenedetti	TELEPHONE: (707) 588-5029
LICENSING EVALUATOR NAME: Farhaan Sarangi	TELEPHONE: 707-588-5034
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023

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-20230214161618

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
	VISIT DATE: 04/11/2023

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

During two subsequent complaint investigation inspections dated for March 6, 2023 and April 4, 2023, LPA toured Resident’s room and observed fruits and yogurts located in the refrigerator. Furthermore, during interviews, LPA could not prove or disprove that the facility does not meet Food Service needs due to inconsistent statements made during the course of the investigation. LPA could not corroborate the allegation.

Complaint alleges Personal Rights. LPA conducted interviews, LPA could not prove or disprove that the facility does not give Personal Rights to the residents in care due to inconsistent statements that were made during the course of the investigation. LPA could not corroborate the allegation.

Complaint alleges Physical Plant issue-No heat in room and kitchen sink is leaking. During the opening of the complaint on February 16, 2023, LPA took a tour of the facilities Memory Care Unit and found it to be clean and at a comfortable temperature with all exits free from obstruction. Furthermore, LPA toured six resident rooms that were found to be clean and at a comfortable temperature. LPA observed no water leaking from any aspect of the room where water is dispensed. On April 4, 2023, LPA conducted a subsequent complaint investigation inspection, toured the facility and found the facility to be clean and at a comfortable temperature with all exits free from obstruction. LPA could not corroborate the allegation.

A finding that the complaint allegations Food Service, Personal Rights and Physical Plant issue-No heat in room and kitchen sink is leaking are unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview was conducted and a copy of this was report was signed and given to the Assistant Administrator.

SUPERVISOR'S NAME: Hope DeBenedetti	TELEPHONE: (707) 588-5029
LICENSING EVALUATOR NAME: Farhaan Sarangi	TELEPHONE: 707-588-5034
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2