486803815-8-21-2026-21-AS-CMAZ-DXHTK5-20260901144722

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 486803815
Report Date: 08/21/2026
Date Signed: 08/21/2026 02:31:54 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
05/27/2026 and conducted by Evaluator Ethel Contreras

PUBLIC

COMPLAINT CONTROL NUMBER: 21-AS-20260527144544

FACILITY NAME:	AMERICAN ASSISTED LIVING		FACILITY NUMBER:	486803815
ADMINISTRATOR:	ANIRUDH WADHWA		FACILITY TYPE:	740
ADDRESS:	405 KINGS WAY		TELEPHONE:	(510) 604-3825
CITY:	SUISUN CITY	STATE: CA	ZIP CODE:	94585
CAPACITY:	0	CENSUS:	DATE:	08/21/2026
		UNANNOUNCED	TIME BEGAN:	01:49 PM
MET WITH:	Maria Villa- Supervisor		TIME COMPLETED:	02:35 PM

ALLEGATION(S):

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Physical Abuse
Reporting Requirements

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Contreras arrived unannounced to deliver findings to the above allegation. LPA was greeted by supervisor Maria Villa. During the course of the investigation, the Department requested and reviewed documents, conducted interviews, and made observations. Facility has closed and is under new ownership.

LPA interviewed staff and residents, all residents interviewed did not observe or have witnessed any residents being handled aggressively or in an abusive manner. Five out of five witness interviews did not report any physical abuse witnessed or had concerns regarding physical abuse occurring in facility. All five out of five witnesses did not observe any abuse toward R1. Four out of four staff interviewed did not report witnessing any physical abuse or handling residents in an aggressive manner.
R1 demonstrated to LPA that a staff grabbed R1 by the arms.

continued onto 9099-C.....

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Ethel Contreras
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2026

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-20260527144544

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: AMERICAN ASSISTED LIVING	FACILITY NUMBER: 486803815
	VISIT DATE: 08/21/2026

NARRATIVE

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continued from 9099....

During an additional LPA visit, LPA interviewed R1 a second time to ask about staff grabbing them but R1 did not have recollection of the event and did not remember speaking with LPA. Due to conflicting information, although the allegation may have happened or is valid, there is not preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Allegation regarding reporting requirements. Based on LPA interview with involved parties , CCL is unable to provide sufficient collaboration regarding allegation. Licensee was unavailable to interview and additional interview was not sufficient to substantiate allegation. Although the allegation may have happened or is valid, there is not preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies cited.

Copy of report given and read.

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Ethel Contreras
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2026

LIC9099 (FAS) - (06/04)

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