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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496803698
Report Date: 03/21/2025
Date Signed: 03/21/2025 02:32:39 PM

Document Has Been Signed on 03/21/2025 02:32 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:VINEYARD AT FOUNTAINGROVE, THEFACILITY NUMBER:
496803698
ADMINISTRATOR/
DIRECTOR:		SANDHU,RAJVIRFACILITY TYPE:
740
ADDRESS:200 FOUNTAINGROVE PKWYTELEPHONE:
(707) 544-4909
CITY:SANTA ROSASTATE: CAZIP CODE:
95403
CAPACITY: 64CENSUS: 22DATE:
03/21/2025
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:CEO of One Life Senior Living, Dan Williams, VP Quality Assurance, Joe Diagle of Frontier Living, and Administrator, Denise Downey, One Life Senior Living LLC TIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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A Subsequent Non-Compliance Conference (NCC) was conducted today in the Santa Rosa Regional Office. Present in the meeting were, Regional Manager, Carla Nuti-Martinez, Licensing Program Manager, Bethany Moellers, and Licensing Program Analyst (LPA) Shannan Hansen, met with Facility: VP Quality Assurance, Joe Diagle, CEO, Dan Williams of One Life Senior Living LLC. & Administrator, Denise Downey for the purpose of reviewing issues during Subsequent Non-Compliance Conference. Original NCC conducted 4/17/2024.

This office meeting is being conducted to discuss concerns identified by the Community Care Licensing Agency regarding the operation of The Vineyard at Fountaingrove 496803698. Areas of compliance not limited to below were discussed:



· Financial Solvency - Facility failed to comply with auditor review (Audit #1). Auditor attempted to engage with facility after initial opening of review 9/2023, 12/28/2024, 1/29/2024, 2/20/2024, & 3/7/2024 with no compliance. Subsequent audit was requested (Audit #2) which revealed facility is not solvent operating in a deficient. Subsequent monitoring was request by CCLD and facility has been non-compliant with providing records or meeting deadlines and extensions granted by auditor. Last deadline of 2/24/2025 was not met.
· Change of Management Company in the building prior to CCL approval, new license issued 3/4/2025.
· Fire clearance concerns (Fire Department involvement) /Firewatch
· Insufficient care and supervision & medication errors as previous multiple citations
· Administer duties/qualifications -
· Clearing POCs timely
· Reporting Requirements
· Facilities future compliance
· POC not being cleared
· Elopements

Continue on LIC 809-C

SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Shannan Hansen
LICENSING EVALUATOR SIGNATURE: DATE: 02/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/03/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: VINEYARD AT FOUNTAINGROVE, THE
FACILITY NUMBER: 496803698
VISIT DATE: 03/21/2025
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Continued from LIC809


Technical Support Services (TSP) was offered during non-compliance meeting on 4/17/2024, Licensee informed they would let CCL know if interested in engagement. During today’s meeting TSP engagement was encouraged.

Since the 4/15/2024 NCC office meeting CCL has received a total of 19 complaints, 3 Complaints were delivered along with citations at todays meeting.

LPA emailed copies of current and past due civil penalties at the request of ED Denise Downey on 1/31/2025.

Licensee and management company were informed that the NCC plan will remain in effect with the change of ownership under review with the application unit.

Onelife Management company was provided a copy of the non-compliance plan, LIC9111 during today's office meeting. Onelife agrees to provide the consulting agreement between FM group prior to change of management.

SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Shannan Hansen
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2025
LIC809 (FAS) - (06/04)
Page: 2 of 2