496803807-9-15-2026-21-AS-BMOS-DZ8PHA-20261026111936

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 496803807
Report Date: 09/15/2026
Date Signed: 09/15/2026 06:04:52 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
06/03/2026 and conducted by Evaluator Dina Alviso

PUBLIC

COMPLAINT CONTROL NUMBER: 21-AS-20260603092834

FACILITY NAME:	COGIR OF ROHNERT PARK		FACILITY NUMBER:	496803807
ADMINISTRATOR:	MENDOZA, RAFAEL OMAR		FACILITY TYPE:	740
ADDRESS:	4855 SNYDER LANE		TELEPHONE:	(707) 585-7878
CITY:	ROHNERT PARK	STATE: CA	ZIP CODE:	94928
CAPACITY:	75	CENSUS: 49	DATE:	09/15/2026
		UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Dolly Bindra-Administrator		TIME COMPLETED:	06:00 PM

ALLEGATION(S):

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Staff did not prevent a resident from threatening another resident with a knife

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alviso conducted a complaint inspection, on 9/15/26 at approximately 2:20pm, and met with Cogir of Rohnert Park Administrator, Dolly Bindra, and Cogir Administrator, Omar Mendoza

Reporting party (RP) alleges "staff did not prevent a resident from threatening another resident with a knife".

The facility has a smaller portion of the building that is an RCFE, licensed to provide assisted living, located on the first and second floors of the building. The rest of the units in the main building and on the property are rented units to independent individuals, they are not residents of the RCFE. The common areas in the building and property are shared by all residents, in the RCFE units and the residents of the independent rented units. The facility does not operate a memory care unit.

LPA conducted interviews with staff, and other related parties. LPA reviewed resident file, and facility records. Interviews conducted provided different information from different parties regarding the incident and the allegation.
Continued on LIC9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Dina Alviso
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2026

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-20260603092834

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: 09/15/2026

NARRATIVE

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Per review of records, and interviews, the investigation revealed that the incident was addressed by the facility staff once notified of the incident regarding an RCFE resident, R1, who had a knife held to their neck area by an independent resident (I1) who is not part of the RCFE.

The facility did report the incident as required. Per review of records and conducted interviews, there has been no similar incident that has occurred in the past by this independent resident (I1). Per interviews with staff, residents of the RCFE are able to have access to utensils; It was unknown where the knife came from that I1 resident found in the bistro that they used in the incident with R1.

R1 is still residing in the facility and per record reviews/interviews, is at their baseline; R1 is observed to be attending activities, and meals in the facility.

I1 resident is still residing in their independent unit, they were notified of inappropriate behavior regarding the incident and their behavior. I1 received Cogir's house rules for all residents on-site, which was provided with their rental agreement.

Administrator stated that after the reported incident they had training with staff to help ensure resident rights and safety. LPA obtained copies of training held with staff regarding the resident incident that occurred.

There was no information obtained to support that a violation occurred regarding "staff did not prevent a resident from threatening another resident with a knife".

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. 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 Administrator Dolly Bindra.

SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Dina Alviso
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2026

LIC9099 (FAS) - (06/04)

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