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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 496803807
Report Date: 08/14/2025
Date Signed: 08/14/2025 05:25:38 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
07/23/2025 and conducted by Evaluator Dina Alviso
PUBLIC
COMPLAINT CONTROL NUMBER: 21-AS-20250723170611
FACILITY NAME:COGIR OF ROHNERT PARKFACILITY NUMBER:
496803807
ADMINISTRATOR:ORDING, KELLYFACILITY TYPE:
740
ADDRESS:4855 SNYDER LANETELEPHONE:
(707) 585-7878
CITY:ROHNERT PARKSTATE: CAZIP CODE:
94928
CAPACITY:75CENSUS: 43DATE:
08/14/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Kelly Ording-AdministratorTIME COMPLETED:
05:40 PM
ALLEGATION(S):
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Staff forced a resident to sit in the facility dining room.
Medications are not provided to the resident as prescribed
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alviso conducted a complaint inspection, on 8/14/2025 at approximately 10am, and met with the Administrator Kelly Ording.

Reporting party alleges "staff forced a resident to sit in the facility dining room and medications are not provided to the resident as prescribed".

LPA reviewed facility records, staff file, and resident, R1 & R2, files. LPA conducted interviews with staff and other related parties. Staff, S2, has required hiring documents, required fingerprint clearance, and required training, for caregiver/medication-technician, per file reviews. LPA obtained copies of requested records.

Investigation revealed that per LPA's review of medication records, MARs records, and interviews, the residents, R1 and R2 are receiving their medications as prescribed. The investigation revealed that per conducted interviews, and review of records, there was no information obtained that resident is forced to sit in the dining room.

Continued on LIC9099C..
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Dina Alviso
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 21-AS-20250723170611
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: COGIR OF ROHNERT PARK
FACILITY NUMBER: 496803807
VISIT DATE: 08/14/2025
NARRATIVE
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Per review of facility records, early am medications are provided approximately at 6:00am, morning medications are provided from 7am -9am, noon medications from 11am to 1pm, evening medications from 4pm to 6pm, and bedtime medications starting at 8pm. Medications/Critical medications would be provided within 30 minutes before scheduled time ordered or 30 minutes after scheduled time ordered.

The investigation revealed that there was differing information obtained from information provided to the Department regarding allegations. There was no information obtained that supported the violations had occurred.

Based on LPAs observations, record reviews, interviews with staff, and information obtained from other related party(s) there is insufficient information to prove or disprove the allegation of "staff forced a resident to sit in the facility dining room, and medications are not provided to the resident as prescribed". 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.
Exit interview conducted with Kelly Ording, Administrator.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Dina Alviso
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2