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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486803806
Report Date: 02/20/2025
Date Signed: 02/21/2025 08:56:25 AM

Document Has Been Signed on 02/21/2025 08:56 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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, THEFACILITY NUMBER:
486803806
ADMINISTRATOR/
DIRECTOR:		WHINERY,MORGANFACILITY TYPE:
740
ADDRESS:3350 CHERRY HILLS COURTTELEPHONE:
(707) 425-3588
CITY:FAIRFIELDSTATE: CAZIP CODE:
94534
CAPACITY: 250TOTAL ENROLLED CHILDREN: 0CENSUS: 161DATE:
02/20/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:50 AM
MET WITH:Morgan Whinery, AdministratorTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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Licensing Program Analysts (LPAs), Shannan Hansen & Ethel Contreras arrived unannounced at facility for the purpose of conducting a Required 1 year inspection. LPAs met with Administrator, Morgan Whinery. Facility is a 3 story building that currently has 110 residents living in the assisted living (AL) portion and 52 residents living in the Memory Care (MC) portion of the community. There are 13 residents receiving Hospice Services at this time and the facility has a Waiver approval for up to 15 Hospice residents.

At approximately 11:20am LPAs toured the facility with Administrator & Maintence, Frank Taitano. The tour of the facility included eleven resident apartments, activity rooms, library, salon, dining rooms, kitchen and outdoor patios. All interior parts of the facility were found to be a comfortable temperature measuring between 73 to 78 degrees F. Exits and pathways were free from obstructions. Delayed egress doors from the memory care units have audible alarms when doors are opened without access codes. Hot water temperature measured within regulation of 105 to 120 degrees F in four of eleven rooms tested; although four memory care rooms and three assisted living rooms were found to be between 120.2 degrees F to 125.2 degrees F as observed by LPAs, Administrator & Maintence at approximately 12 PM (see LIC 809-D), Resident bathrooms had required slip resistant mats and grab bars. While touring memory care at approximately 12:10 PM LPAs and Administrator observed laundry room unlocked with cleaning chemicals on the shelf (see LIC 809-D), staff locked door. LPA observed at least a minimum of a 2 day supply of perishable and 7 day supply of non-perishable food necessary for residents in care. Food was found to be handled and stored in a safe manner. Dining rooms and kitchen were inspected and maintained per regulation. Menus with snack and beverages are available to residents. Activity schedules are posted. Facility has a theater in AL & memory care and multiple indoor and outdoor sitting areas and a private dining area.

Fire extinguishers were last serviced 1/9/2025. Fire safety system including smoke detectors and carbon monoxide detectors and sprinklers were last inspected by Fire Dept. on 12/11/2024. Disaster drills are conducted quarterly with the last being 2/10/2025. Facility has ordered five generators to power essential areas of facility should there be a power outage.


Continue on LIC809C
Bethany MoellersTELEPHONE: (707) 588-5026
Shannan HansenTELEPHONE: 707-588-5026
DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 02/20/2025
NARRATIVE
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Continued from LIC809

At approximately 2:00 PM, LPA reviewed a sample of AL & MC centrally stored medication records and found to be in compliance. LPAs began review of 10 resident and 10 staff records but were unable to finish and will return at a later date to complete inspection.



The following deficiencies were observed (see LIC 809D) 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. Exit interview conducted and appeal of rights provided..
SUPERVISOR'S NAME: Bethany MoellersTELEPHONE: (707) 588-5026
LICENSING EVALUATOR NAME: Shannan HansenTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/21/2025 08:56 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 02/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
CCR
87303(e)(2)
87303(e)(2) Maintenance and Operation- Water supplies and plumbing fixtures shall be maintained as follows: Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C).

This requirement is not met as evidenced by:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in 7 out of 11 (4 in memory care) faucets accessible to residents in care ranged from 120.2 to 125.2 degrees F which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/21/2025
Plan of Correction
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Licensee/Administrator to ensure the hot water is monitored and under 120.degrees Fahrenheit, and not to be under 105. degrees Fahrenheit. Monitor the hot water for a period of one week (7 days). Submit a copy of the hot water log, and a plan on how the facility will ensure the hot water is maintained in compliance with regulation. Submit plan of correction by 2/21/2025, and follow up with copy of hot water log and maintenance plan by 2/28/25.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Bethany MoellersTELEPHONE: (707) 588-5026
Shannan HansenTELEPHONE: 707-588-5026

DATE: 02/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/20/2025

LIC809 (FAS) - (06/04)
Page: 3 of 4


Document Has Been Signed on 02/21/2025 08:56 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 02/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
CCR
87705(f)(2)

87705 Care of Persons with Dementia:(f) The following shall be stored inaccessible to residents with dementia:(2) Over-the-counter medication... alcohol... and toxic substances...


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, Licensee did not comply with the section cited above. During tour of memory care LPAs and Administrator observed laundry room unlocked with cleaning chemicals on shelves. This is a potential health and safety risk to residents in care.
POC Due Date: 02/27/2025
Plan of Correction
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Licensee to submit self certification that training for Regulation 87705(f)(2) will be conducted for all staff by POC due date of 02/27/2025. Training to review items that are inaccessible to residents in care. Licensee to conduct Inservice Training and submit a sign in sheet to CCL that includes the following: Date, Training Topic, Name/Job Role, and Signatures by POC due date of 02/27/2025.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Bethany MoellersTELEPHONE: (707) 588-5026
Shannan HansenTELEPHONE: 707-588-5026

DATE: 02/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/20/2025

LIC809 (FAS) - (06/04)
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