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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496802043
Report Date: 05/14/2025
Date Signed: 05/14/2025 04:19:15 PM

Document Has Been Signed on 05/14/2025 04:19 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:PROGRESS SONOMAFACILITY NUMBER:
496802043
ADMINISTRATOR/
DIRECTOR:		ELIZABETH PICKERINGFACILITY TYPE:
772
ADDRESS:3400 MONTGOMERY DRIVETELEPHONE:
(707) 526-6902
CITY:SANTA ROSASTATE: CAZIP CODE:
95405
CAPACITY: 10CENSUS: 10DATE:
05/14/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:53 PM
MET WITH:Senna Wolter, Program DirectorTIME VISIT/
INSPECTION COMPLETED:
04:33 PM
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Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by counselor. Program Director (PD) Sena Wolter greeted LPA shortly after arrival. Elizabeth Pickering, Administrator contacted by phone. Admin confirmed new PD is Sena Wolter . Facility contact information was reviewed.

At approximately 2:30pm LPA and PD toured the building and grounds. The facility was found to clean and be at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered. Kitchen cabinet containing cleaning supplies was locked. Kitchen drawer with sharp knives locked.

All bedrooms were equipped with lighting, night stand, and chest of drawers. All bedrooms were clean and in good repair. Extra hygiene products and linens were available. Water temperature in sink accessible to clients in care measured at 127.7 degrees F in the kitchen and 136.6 degrees F in the downstairs apartment, which are not within the allowable range of 105 to 120 degrees F. PD immediately turned down water heaters. Facility has two water heaters. LPA and PD got reading of 114.9 in resident room #4 which is within the allowable range of 105 to 120 degrees F.

Fire extinguishers were last inspected 1/15/25. Smoke/Carbon Monoxide detector was tested by vendor, LPA review report dated 5/12/25, no violations noted. Facility’s last quarterly disaster drill was conducted on 5/8/25.

Continued on 809C...
NAME OF LICENSING PROGRAM MANAGER: Victoria Bertozzi
NAME OF LICENSING PROGRAM ANALYST: Christi Coppo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/14/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: PROGRESS SONOMA
FACILITY NUMBER: 496802043
VISIT DATE: 05/14/2025
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Continued form 809...

At approximately 2:45pm LPA and counselor conducted a spot check of medication and medication records. Medication is centrally stored in locked lockers in staff office room. No deficiencies.

Additionally, LPA discussed with PD and counselor Incident Report received by CCL on 11/7/24 indicating a client (C1) had accessed their prescribed Ambien. LPA clarified client was prescribed both Ativan and Ambien. LPA reviewed medication orders for C1 with counselor. LPA clarified with counselor that it was the Ambien that C1 grabbed and took. Per incident report, C1 was transported to the hospital by ambulance at 9:00pm that same evening. C1 returned to the facility the next morning 11/3/25 at 7:00am. Staff provided one dose of Ativan and then transferred the remainder of C1's medications to Sonoma County Behavioral Health Medication clinic. Counselor explained medication administration process to LPA and demonstrated process live with LPA. Medication is administered in the medication room with clients seated on one side of the desk and staff on the other side with client's medication container. When staff opened the medication bottle the client reached over and grabbed the additional pills out of the bottle. Unless medications are being administered, medication remains locked and inaccessible to clients in care.

At approximately 3:00pm LPA conducted review of five [5] staff records. All required documentation present.



At approximately 3:40pm LPA conducted a review of five [5] of ten[10] client records. All required documentation present.


Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit:

LIC500- Personnel Report
LIC308- Designation of Responsibility

Exit interview conducted with PD and a copy of this report was given.
NAME OF LICENSING PROGRAM MANAGER: Victoria Bertozzi
NAME OF LICENSING PROGRAM ANALYST: Christi Coppo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
LIC809 (FAS) - (06/04)
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