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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486803868
Report Date: 02/08/2022
Date Signed: 02/08/2022 11:35:12 AM

Unfounded


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
09/17/2021 and conducted by Evaluator Jill Nakagawa
COMPLAINT CONTROL NUMBER: 21-AS-20210917161750
FACILITY NAME:CAREWELL AT LAWLER RANCH, LLCFACILITY NUMBER:
486803868
ADMINISTRATOR:COLEMAN, ROBERTFACILITY TYPE:
740
ADDRESS:237 LAWLER RANCH PARKWAYTELEPHONE:
(707) 592-4004
CITY:SUISUN CITYSTATE: CAZIP CODE:
94585
CAPACITY:6CENSUS: 5DATE:
02/08/2022
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Ron-Mark Adriano, AdministratorTIME COMPLETED:
11:40 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident sustained multiple pressure injuries while in care
Facility staff is incapable of properly caring for resident
Facility staff not meeting a resident's incontinent needs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 2/08/2022 Licensing Program Analyst (LPA) Nakagawa conducted a complaint investigation visit to deliver findings to the facility and was greeted by Administrator, Ron-Mark Aridano. During the investigation, the Department toured the facility, reviewed records, conducted interviews with staff, clients and outside parties.

The complaint alleges that a resident sustained multiple pressure injuries while in care, facility staff is incapable of properly caring for resident, and facility staff not meeting a resident's incontinent needs. Based on interviews with staff, residents, outside parties and a review of medical records, the Department was unable to prove that the Resident (R1) had sustained pressure injuries. In addition, R1 stated they had never developed a pressure injury while at the facility and that staff keep R1 very clean. A review of records indicate that R1 is re-positioned every two (2) hours. An observation of R1 revealed that R1 is clean, dry and did not show any indication of a pressure injury.


Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2022
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-20210917161750
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: CAREWELL AT LAWLER RANCH, LLC
FACILITY NUMBER: 486803868
VISIT DATE: 02/08/2022
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
Cont. from 9099

This agency has investigated the complaint alleging resident sustained multiple pressure injuries while in care, facility staff is incapable of properly caring for resident, facility staff not meeting a resident's incontinent needs. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

No deficiencies cited at today’s inspection.

Exit interview conducted.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2