486804351-7-24-2026-21-AS-KMOA-DWNT74-20260805142806

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 486804351
Report Date: 07/24/2026
Date Signed: 07/24/2026 02:45:45 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
06/08/2026 and conducted by Evaluator Ethel Contreras

PUBLIC

COMPLAINT CONTROL NUMBER: 21-AS-20260608162543

FACILITY NAME:	SERENITY LIVING HOME, THE		FACILITY NUMBER:	486804351
ADMINISTRATOR:	WADHWA, ANIRUDH		FACILITY TYPE:	740
ADDRESS:	405 KINGS WAY		TELEPHONE:	(707) 759-4887
CITY:	SUISIN CITY	STATE: CA	ZIP CODE:	94585
CAPACITY:	30	CENSUS: 22	DATE:	07/24/2026
		UNANNOUNCED	TIME BEGAN:	12:46 PM
MET WITH:	Anirudh Wadhwa-Administrator		TIME COMPLETED:	02:55 PM

ALLEGATION(S):

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Facility is unkept and malodorous
Resident's needs not being met

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Contreras arrived unannounced to deliver findings to the above allegations. LPA was greeted by Supervisor/Med Tech Maria Villa. Administrator Anirudh Wadhwa was unable to attend the visit. During the course of the investigation, the Department requested and reviewed documents, conducted interviews, and made observations.

Reporting Party (RP) alleges facility is unkept and malodorous. LPA visitied facility on 6/08/2026 to initiate complaint and conducted a walk-through of the facility. LPA did not observe any malodors and facility appeared to be clean and in good conditions. On 6/09/2026 LPA conducted a Post-Licensing Inspection visit and conducted another walk through of all rooms in the facility. LPA did not observe any malodors or uncleaniness in premises. No deficiences were cited during the visit. LPA conducted a health and safety walk through today 7/24/2026 of entire facility premises and rooms and observed all bedsheets to be cleaned and free of odors. In addition, bathrooms accesible to residents were cleaned and were stocked with toilet paper, paper towels, and soap.
continued onto 9099-C....

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Ethel Contreras
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2026

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-20260608162543

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: SERENITY LIVING HOME, THE	FACILITY NUMBER: 486804351
	VISIT DATE: 07/24/2026

NARRATIVE

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continued from 9099......

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

RP alleges resident's needs not being met. LPA conducted interviews and made observations. LPA conducted a walk through of facility and all rooms were found to be clean and at a comfortable temperature. LPA conducted interviews and residents stated they are being bathed, fed and regular cleaning occurs. Three out of three residents reported feeling safe and did not have concerns with facility. No additional reported concerns were discussed during resident interviews. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies cited during today's interview.

Copy of report given and read with staff Maria Villa.

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Ethel Contreras
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2026

LIC9099 (FAS) - (06/04)

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