496801090-10-20-2025-21-AS-BMOS-DRENEQ-20260218092418

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 496801090
Report Date: 10/20/2025
Date Signed: 10/20/2025 02:21:16 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
10/17/2025 and conducted by Evaluator Dina Alviso

PUBLIC

COMPLAINT CONTROL NUMBER: 21-AS-20251017145442

FACILITY NAME:	HANNA HOUSE RIDLEY		FACILITY NUMBER:	496801090
ADMINISTRATOR:	HANNA, DAVID		FACILITY TYPE:	740
ADDRESS:	1840 RIDLEY AVENUE		TELEPHONE:	(707) 591-0980
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95403
CAPACITY:	28	CENSUS: 22	DATE:	10/20/2025
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	David Hanna-Administrator		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Resident's medication is not being provided as prescribed

Resident's personal rights are being violated

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alviso, conducted a complaint inspection, approximately 10:00am on 10/20/25, and met with Resident Care Coordinator(RCC) Karrie Hanna. Administrator David Hanna arrived to to meet with the LPA.

Reporting party alleges that "resident's medication is not being provided as prescribed, and resident's personal rights are being violated". The LPA reviewed resident, R1, records, including medication records, medical documentation,medical assessment, facility care plan, and Hospice Care plan; The LPA interviewed staff, and other related parties regarding the allegations.

The investigation revealed that per record reviews, medications are being provided to the resident, and they are being povided as prescribed by the Physician. R1's medication list was provided by the hospital upon R1's discharge to the facility, on 10/10/25. R1 had a change in medications by the Physician on 10/11/25. Hospice agency was at the facility, on 10/10/25 and 10/11/25, to see the resident. Hospice is to oversee resident's medication and adjust the medication as needed, with Physician order/approval.
Continued on LIC9099C..

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Dina Alviso
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025

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-20251017145442

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: HANNA HOUSE RIDLEY	FACILITY NUMBER: 496801090
	VISIT DATE: 10/20/2025

NARRATIVE

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Hospice agency was at the facility, on 10/10/25 and 10/11/25, to see the resident. Hospice will be overseeing resident's medication (s) and adjust the medication as needed, with Physician approval/order. Per review of hospice records, there was no documentation regarding concerns with how resident's medications were being provided to them, and no concerns on the care being provided to the resident.

LPA observed the lunch meal being provided to residents', including R1. Per interviews with staff and other parties, meals are always provided, snacks, and if someone wants seconds of food and/or another item, the facility will provide this to the resident. The resident's personal phone had no charger, and staff would charge the phone for the resident. This would be done in the kitchen and/or in the facility office. R1's responsible party decided to collect the cell phone while at the facility. LPA interviewed staff and other parties regarding staff speaking inappropriately to the residents' and/or staff handling residents in a rough manner.

Per investigation and review of records, including medical records, medication records, hospice records, interviews with staff, interviews with other related parties, and staff records, there was no information obtained to support that violations had occurred regarding the allegations reported.

Based on LPA's review of records, including medical records, medication records, hospice records, interviews with staff, other related parties,staff records, and related information obtained during the investigation, the allegations of "resident's medication is not being provided as prescribed, and resident's personal rights are being violated" are Unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

No deficiencies cited.
Exit interview was conducted with the Administrator David Hanna.

SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Dina Alviso
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025

LIC9099 (FAS) - (06/04)

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