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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 496803049
Report Date: 08/04/2026
Date Signed: 08/04/2026 06:08:10 PM

Unfounded


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
01/30/2026 and conducted by Evaluator Dina Alviso
PUBLIC
COMPLAINT CONTROL NUMBER: 21-AS-20260130125255
FACILITY NAME:VARENNA AT FOUNTAINGROVEFACILITY NUMBER:
496803049
ADMINISTRATOR:BUOT, FERDINANDFACILITY TYPE:
741
ADDRESS:1401 FOUNTAINGROVE PKWYTELEPHONE:
(707) 526-1226
CITY:SANTA ROSASTATE: CAZIP CODE:
95403
CAPACITY:322CENSUS: DATE:
08/04/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Brooke Patterson-AdministratorTIME COMPLETED:
06:00 PM
ALLEGATION(S):
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Staff did not allow resident to contract private care services
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alviso conducted a complaint visit, on 8/4/26, and met with Brooke Patterson, Administrator, and Derrick Defino,Executive Director.

Reporting party alleges "staff did not allow resident to contract private care services".

LPA reviewed resident (R1) records, including their admission agreement/contract. The LPA requested copies of resident records, and the Administration staff provided the copies to the LPA. LPA reviewed facility records, and obtained requested copies. LPA conducted interviews with staff, and other related parties regarding the alleged allegation.

The investigation revealed that per R1's contract, Section 4.10, Private Caregivers and Companions-
In the event you require private duty care for a short term illness or injury, you must first make this request known to Varenna management.
Continued on LIC9099....
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Dina Alviso
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2026
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-20260130125255
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: VARENNA AT FOUNTAINGROVE
FACILITY NUMBER: 496803049
VISIT DATE: 08/04/2026
NARRATIVE
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 If Varenna is unable to provide the necessary private duty personnel, then you may hire a private caregiver or companion if they: (1) first register with Varenna and provide proof of licensure and liability insurance; and (2) comply with all of Varenna's policies and procedures for private caregivers and companions. Registration with Varenna is not an endorsement of the private caregivers or companions by Varenna. You shall select such personnel in your discretion and pay for their services.

Record review of, Facility Policy regarding personal care attendants revealed, "Personal Care Attendants- Residents who desire to use a personal care attendant for extended periods of time may do so with prior approval of the Administrator." Procedure #2 of this Policy states, " Personal Care Attendants from outside agencies may be used if approved by the Administrator. The agency shall ensure a criminal clearance on all staff, health screening, appropriate insurance including liability and workers compensation, proof of appropriate employer tax obligations, including but not limited to withholding of state and federal taxes, payment of disability and unemployment insurance. All appropriate labor laws are to be followed and the personal care attendant supervised by an agency administrator familiar with this assisted living community operations".

Information obtained from resident's (R1's) contract regarding "Private Caregivers and Companions" in section 4.10, and from facility's policy regarding "Personal Care Attendants", did not support that a violation had occurred regarding the alleged allegation "staff did not allow resident to contract private care services".

Based on the investigation, the allegation is Unfounded. We have found that the complaint allegation was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

No deficiencies cited.
Exit interview was conducted with Administrator Brooke Patterson, and Executive Director Derrick Defino. Report provided to Administrator.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Dina Alviso
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2