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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486804139
Report Date: 07/11/2024
Date Signed: 07/11/2024 03:40:05 PM

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
04/18/2024 and conducted by Evaluator Dominic Tobola
COMPLAINT CONTROL NUMBER: 21-AS-20240418113927
FACILITY NAME:SOLANO HOUSEFACILITY NUMBER:
486804139
ADMINISTRATOR:HALL, ELIZABETHFACILITY TYPE:
735
ADDRESS:2251,2261,& 2271 S WATNEY WAYTELEPHONE:
(530) 758-2160
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY:32CENSUS: 23DATE:
07/11/2024
UNANNOUNCEDTIME BEGAN:
01:38 PM
MET WITH:Wendi Counta, AdministratorTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff are not properly trained to administer resident's medications
Facility does not have adequate staffing to meet resident's needs
Staff does not provide adequate food service to residents in care
INVESTIGATION FINDINGS:
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On 7/11/2024, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of delivering complaint investigation findings and was greeted by Administrator, Wendi Counta. LPA toured the facility, interviewed staff, reviewed staff records, conducted medication record review and made observations during the course of the investigation.

Complaint alleges, staff are not properly trained to administer resident medications. Based upon a sample review of staff training records, LPA found that staff who provide medication service have a form of medication training on file. Due to a lack of corroborating evidence, the allegation is unsubstantiated.

Complaint alleges facility staff does not have adequate staffing to meet resident's needs during overnight hours. Based upon a sample review of staff timesheets from 4/1/2024 - 4/14/2024, LPA found that there were between 1-2 awake staff per overnight shift at all hours. Due to a lack of corroborating evidence, the allegation is unsubstantiated. Continued onto LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2024
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-20240418113927
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: SOLANO HOUSE
FACILITY NUMBER: 486804139
VISIT DATE: 07/11/2024
NARRATIVE
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Complaint alleges staff does not provide adequate food service to residents in care regarding no designated kitchen staff. Based upon interviews with staff (S1) it was indicated that they had previous food operation experience and was given primary responsibility for meal preparation and cooking which meets regulation requirements based on facility capacity. In addition, during tour of the facility, LPA conducted an interview with new designated full-time cooking staff (S2) indicating adequate services. Due to inconsistent information gathered, the allegation is found to be unsubstantiated.

A finding that the complaint allegations, staff are not properly trained to administer resident's medications, facility does not have adequate staffing to meet resident's needs and staff do not provide adequate food service to residents in care are unsubstantiated meaning that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiency cited.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2