486804234-4-27-2026-21-AS-VBEI-DU3TB7-20260514143440

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 486804234
Report Date: 04/27/2026
Date Signed: 04/27/2026 01:58:17 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
03/12/2026 and conducted by Evaluator Ali Deniz

COMPLAINT CONTROL NUMBER: 21-AS-20260312125452

FACILITY NAME:	ANICA HOMECARE		FACILITY NUMBER:	486804234
ADMINISTRATOR:	VILLEGAS, ART		FACILITY TYPE:	740
ADDRESS:	1001 BRETON DRIVE		TELEPHONE:	(707) 344-0839
CITY:	FAIRFIELD	STATE: CA	ZIP CODE:	94533
CAPACITY:	6	CENSUS: 4	DATE:	04/27/2026
		UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Administrator/Licensee, Art Villegas		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Resident is not provided medications as prescribed.
Resident is not provided appropriate meals/special diet as required.
Resident is not provided appropriate incontinent care.
Resident is forced to stay in bed.
Violation of resident's personal rights.

INVESTIGATION FINDINGS:

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At approximately 09:35 AM, Licensing Program Analyst (LPA) Ali Deniz arrived unannounced to deliver findings for a complaint investigation regarding the above allegation and met with Administrator, Art Villegas.

During the course of the investigation, the Department conducted interviews, reviewed documents, and made observations. The following allegations were investigated: “Resident is not provided medications as prescribed, Resident is not provided appropriate meals/special diet as required, Resident is not provided appropriate incontinent care, Resident is forced to stay in bed, and Violation of resident’s personal rights.”

The reporting party (RP) reported concerns regarding Resident 1 (R1), including medication management, diet, incontinent care, mobility, and personal rights. No alleged abuser was identified.

During the investigation, LPA conducted interviews, reviewed available records, and made observations.
Continued on LIC9099-C page...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Ali Deniz
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2026

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-20260312125452

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: ANICA HOMECARE	FACILITY NUMBER: 486804234
	VISIT DATE: 04/27/2026

NARRATIVE

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Continued from LIC9099 page...

“Resident is not provided medications as prescribed” – R1 is receiving hospice services (admitted 11/13/2025). Hospice Nurse confirmed R1’s care was adjusted under physician’s orders for comfort-focused treatment, including discontinuation of blood glucose monitoring and EpiPen use. Medications are aligned with hospice plan of care. No evidence was obtained of medication mismanagement or failure to administer prescribed medications.

“Resident is not provided appropriate meals/special diet as required” – Records reviewed indicated R1’s dietary plan was adjusted under hospice physician orders for comfort care. No special or restricted diet was identified. Observations did not identify concerns with meal service. No evidence supported the allegation.

“Resident is not provided appropriate incontinent care” – Staff reported assistance is provided with toileting needs. LPA conducted a facility tour and interviewed staff, who confirmed bedpans are not used for R1 or other residents. No concerns were observed during the visit. No evidence indicated care was not provided.

“Resident is forced to stay in bed” – Staff reported R1 has mobility limitations and may refuse to get out of bed, and is encouraged to participate in activities as tolerated. Documentation provided showed resident engagement in activities. Observations did not indicate residents were confined to beds. No evidence supported the allegation.

“Violation of resident’s personal rights” – Allegation involved an unknown male entering R1’s room inappropriately. Staff interviews and observations did not identify any such incident. R1 denied the allegation. No evidence was obtained to substantiate the claim.

Based on interviews conducted, observations made, and information obtained, these allegations are Unsubstantiated. A finding that the complaint is Unsubstantiated means there is not a preponderance of evidence to prove the alleged violation occurred.

Exit interview conducted. Report discussed and provided to Administrator. Signature confirms receipt.

SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Ali Deniz
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2026

LIC9099 (FAS) - (06/04)

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