Admission, assessment, and eviction
Cited in 2 reports, with 2 deficiencies in total.
1920 GROSSE AVENUE, Santa Rosa CA 95404
6 bedsLatest official report Jan 23, 2026Licensed
The available records show 2 Type A and 5 Type B deficiencies for this facility.
1 later report, on Jan 23, 2026, recorded no deficiencies, though the records do not say whether they were follow-ups.
Both classifications are published by California CDSS and are shown as published. SeniorLivingFacts does not rename them or add a severity level of its own.
Counts cover the five-year public record. Typical figures are the median for the 111 Sonoma County facilities licensed for 6 or fewer beds.
In the available public five-year record, CCLD published 9 reports for this facility: 6 inspections, 1 complaint investigation, and 2 licensing or administrative records.
Those records contain 2 Type A and 5 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
More than the typical 5
1 in the last 12 months
More than the typical 4
0 in the last 12 months
More than the typical 1
0 in the last 12 months
More than the typical 2
0 in the last 12 months
Most this size also have none
0 in the last 12 months
Last 36 months
Topics cited in more than one report during the last 36 months. A repeat may show a pattern worth asking about. Each date opens its report below.
Cited in 2 reports, with 2 deficiencies in total.
All preserved reports from the most recent to the oldest, sortable by report type.
(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in three (3) out of four (4) water temperatures tested exceeded 120 degrees Fahrenheit, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/10/2025 Plan of Correction Licensee/Administrator to ensure the hot water is within regulation at all times-no lower than 105F and no higher than 120F. Administrator will turn down the hot water heater and will continue to monitor the hot water to bring it within regulation. Administrator will log the hot water for a period of one week ensuring compliance with hot water range regulation. Administrator will submit copy of the hot water log for the first four (4) days to CCL on 2/10/2025.
(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health.Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above that one (1) staff member (S1) did not have an LIC 503 Health Screening Report - Facility Personnel on File. In Addition, one (1) staff member (S2) did not have their LIC 503 signed by an authorized health care professional.
POC Due Date: 02/13/2025 Plan of Correction Administrator will submit to Community Care Licensing completed LIC 503 Health Screening Report - Facility Personnel reports by POC Due Date. Administrator will also self certify that all staff member files have been reviewed for required documentation by POC Due Date of 2/13/2025.
(a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in that one (1) of five (5) resident’s files (R1) did not have a 602A Physician's Report for Residential Care Facilities for the Elderly (RCFE), which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/06/2025 Plan of Correction Administrator will submit to Community Care Licensing a completed 602A Physician's Report for Residential Care Facilities for the Elderly (RCFE) for resident 1 (R1) by POC due date of 3/6/2025.
87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year and includes: (E) The prescription number and the name of the issuing pharmacy. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in three (3) residents had errors on their Centrally Stored Medication and Destruction Records. Four (4) errors for resident two (R2). Two errors for Resident three (R3), and 1 error for Resident four (R4) which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/10/2025 Plan of Correction Administrator will Audit all Centrally Stored Medication and Destruction records for all residents and Submit them to Community Care Licensing by POC Due Date of 2/10/2025.
Allegations0 substantiated · 2 unsubstantiated · 0 unfounded
No deficiencies recorded in this report(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review and interview the licensee did not have at least one staff member who has CPR training on duty at all times. Facility has 1 out of 3 caregivers that work at the facility without a valid CPR certificate which poses a potential health, safety risk to residents in care.
POC Due Date: 04/05/2024 Plan of Correction Licensee to ensure that at least one staff on duty has CPR training at all times. Licensee to submit LIC 9098 self certification that staff has been certified for CPR per regulation and that facility will maintain a staff on duty who has CPR training at all times. Self certification to be submitted by POC date of 4/5/24.
(6) When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA/staff observation, records review and interview with the licensee, the licensee did not comply with the section cited above in two out of four resident's medications where not entered into the Centrally Stored Medication log accordingly which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/05/2024 Plan of Correction Facility to submit LIC9098 self-certifying they have conducted staff training on how to properly keep records of medications on CSML to CCL by POC due date to clear the deficiency.
(c) The licensee shall arrange a meeting with the resident, the resident's representative, if any, appropriate facility staff, and a representative of the resident's home health agency, if any, when there is significant change in the resident's condition, or once every 12 months, whichever occurs first, as specified in Section 87467, Resident Participation in Decision Making. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA/Administrator's file review showing that resident's care plans for 1 out of 4 residents (R1) were not been update and signed by the resident of their representative within last 12 months. This is a potential risk to the health and safety of residents in care.
POC Due Date: 04/05/2024 Plan of Correction Administrator agreed to review all resident's care plans, update them accordingly and send self-certification that this process had been done to CCL by POC due date.
California Department of Social Services, Community Care Licensing Division. Public facility history is described by the source as a five-year window. Older records and previous-licensee history may require a regional-office request. Type 741 RCFE-CCRCs, nursing homes, and other care settings are excluded from this page.
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