496803825-8-11-2026-21-AS-VBEI-DWVQ2E-20260812114658

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 496803825
Report Date: 08/11/2026
Date Signed: 08/11/2026 02:53:19 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
06/17/2026 and conducted by Evaluator Robert Frank

COMPLAINT CONTROL NUMBER: 21-AS-20260617095856

FACILITY NAME:	VINE RIDGE SENIOR LIVING		FACILITY NUMBER:	496803825
ADMINISTRATOR:	LUA, CARLA		FACILITY TYPE:	740
ADDRESS:	247 TREADWAY DRIVE		TELEPHONE:	(707) 791-4787
CITY:	CLOVERDALE	STATE: CA	ZIP CODE:	95425
CAPACITY:	99	CENSUS: 43	DATE:	08/11/2026
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Carla Lua, Executive Director		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Gate Door in Memory Care Yard is Not Locking

INVESTIGATION FINDINGS:

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At approximately 9:00 AM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to deliver findings regarding the above allegations and met with facility Administrator Carla Lua.

During the course of the investigation LPA conducted multiple facility visits, conducted interviews, collected and reviewed documents. Complaint alleges that the emergency egress Gate Door in Memory Care (MC) Yard is Not Locking. The MC Garden egress doors are locked in place with electromagnets. When the fire alarm is activated, the magnets will release allowing egress from the doors. On 6/19/2026 LPA inspected the facility’s Memory Care unit garden fire egress doors. The garden has three (3) emergency egress doors. The doors are located in the North-East (door #1) section, the North-West (door #2) section and the South corner (door #3) of the MC garden. LPA observed that doors #1 and #2 were not locking as designed. The wooden gate doors had warped. As a result of the warping the electromagnets were unable to connect and keep the doors locked.
Continued on 9099-C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Robert Frank
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2026

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-20260617095856

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: VINE RIDGE SENIOR LIVING	FACILITY NUMBER: 496803825
	VISIT DATE: 08/11/2026

NARRATIVE

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...Continued from 9099

Instead, door #1 and door #2 were being held shut by rocks placed on the outside of the gates. The rocks holding the doors shut were small and the doors were easily able to be pushed open. As such, the emergency egress pathways were not blocked. When asked about the doors not operating as designed facility Executive Director (ED) Carla Lua stated that the doors were functioning and that the facility landscapers had turned off the electromagnetic locks the previous day so that they could access the MC garden for up-keeping and had failed to turn them back on. ED Lua then confirmed that the power to the locks was turned on. ED Lua then contacted facility maintenance who immediately adjusted the doors so that they would remain locked using the electromagnets. LPA returned to the facility on 7/9/2026. LPA observed that the three (3) MC garden gates were properly locked by the electromagnets as designed. However on the same day, 7/9/2026 LPA observed that the egress door at the South-West end of the MC interior corridor was unlocked and that it was being blocked by a large ottoman. The facility was cited separately for this deficiency on a Case Management inspection. During today’s 8/11/2026 visit, LPA observed all three (3) MC Garden gates to be properly locked. Additionally, LPA observed the egress door at the South-West (SW) end of the MC interior corridor to be secured. LPA tested the delayed egress door at the SW end of the MC interior corridor and LPA observed the delayed egress function to be working as designed. Although the MC units delayed egress doors and locking garden gate doors were not functioning as designed, they were able to be opened in the event of an emergency evacuation.

So, 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.

Exit interview conducted. Copy of LIC-9099 and LIC-9099C discussed and provided to ED Lua. Signature on form confirms receipt of documents.

SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Robert Frank
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2026

LIC9099 (FAS) - (06/04)

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