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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 496803241
Report Date: 08/11/2026
Date Signed: 08/11/2026 11:20:22 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/16/2026 and conducted by Evaluator Marisol Cuadra
PUBLIC
COMPLAINT CONTROL NUMBER: 21-AS-20260716114041
FACILITY NAME:BROOKDALE CHANATEFACILITY NUMBER:
496803241
ADMINISTRATOR:PATRICIA GUSTINFACILITY TYPE:
740
ADDRESS:3250 CHANATE RDTELEPHONE:
(707) 575-7503
CITY:SANTA ROSASTATE: CAZIP CODE:
95404
CAPACITY:140CENSUS: 98DATE:
08/11/2026
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Patrica Gustin (Administrator)TIME COMPLETED:
11:35 AM
ALLEGATION(S):
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-Facility does not have sufficient number of staff at all times to provide the services necessary to meet the resident's needs.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cuadra arrived unannounced to deliver findings regarding the allegation listed above and met with Patricia Gustin, Administrator.

The Department received an allegation of facility does not have sufficient number of staff at all times to provide the services necessary to meet the residents’ needs. The reporting party stated that response times have become unacceptable again, the average response time is between 20 to 30 minutes with times when it takes caregivers over an hour to assist residents with incontinence care. According to reporting party, this issue has been reported to management to compare it with the amount of money that residents are being charged, but care needs not been taken care of. Based on interviews conducted with staff and residents (R1, R2, R3, R4, R5, R6 & R7) in care revealed concerns about the amount of money that they get billed for personal services that are not been provided by the facility, where according to residents the facility don’t have enough caregivers when they call for assistance it takes them an average of 20 to 30 minutes to arrive. Continued into LIC9099C...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
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)
Page: 1 of 3
Control Number 21-AS-20260716114041
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: BROOKDALE CHANATE
FACILITY NUMBER: 496803241
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/12/2026
Section Cited
HSC
1569.269(A)(6)
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§1569.269 Enumerated rights (a) Residents of RCFE shall have all of the following rights: (6) To care, supervision & services that meet their individual needs & are delivered by staff that are sufficient in numbers... & competency to meet their needs. This requirement has not been met as evidence by:
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Administrator agrees to submit a plan to ensure staffing is adequate to meet residents’ needs timely. Written plan will be submitted to CCL by POC due date.
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Based on LPA’s records review of alarm response report, staff schedules for the month of June 2025 & interviews conducted with staff & residents in care, the facility did not ensure that staff on duty was sufficient to respond in a timely manner to assist residents in care which poses an immediate risk to the health & safety of residents in care.
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The Department will be scheduling a meeting to discuss areas of concern and non-compliance.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 21-AS-20260716114041
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: BROOKDALE CHANATE
FACILITY NUMBER: 496803241
VISIT DATE: 08/11/2026
NARRATIVE
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Continued from LIC9099...

The residents expressed that there are patterns including nights, early mornings, and weekends when the number of caregivers is limited. Furthermore, residents stated that staggered shower schedules, back up staff during shift changes and busy mornings might provide help to assist residents in care. Additionally, LPA conduced interviews with staff (S1, S2, S3, S4 S5, S6 & S7) where it was revealed the following: As of 7/23/26, there are 70 residents who reside in the assisted living area where approximately 18 residents who are completely independent, 27 residents need laundry services, 22 residents need assistance with showers, 4 residents need two people assistance, 3 residents have behavioral expressions that requires additional staffing to be present when they need assistance, 15 residents need assistance with dress, grooming, incontinent cares, and escorts to dining room during mealtimes. According to interviews conducted with caregivers, they are struggling to assist residents in care due to lack of staffing during busy times, medication technicians help when medication passing is completed, but it could represent a delay in their availability to come and help with assistance to residents’ care needs. The main concern raised by staff from different shifts is the need for additional caregivers to ensure that residents are being taken care of properly, where at times they must work alone during their shifts, call responses log obtained for the last 24 hour confirmed caregiver’s statements revealing response times taking between 20 to 43 minutes. Based on records review, on 7/23/26, the facility provided itemized record of personal services provided to residents in care who reside in the assisted living area that reveals contradictory information about the amount of residents who are paying for certain services as follow: 26 residents are completely independent, 29 residents need assistance with shower services, 17 residents need incontinent care, 1 resident gets additional staffing assistance due to behavioral expressions. According to facility administrator, it acknowledges the need for additional staffing due to an ongoing issue of care staff, where the facility is in the process of hiring staff for 4 hour shifts to assist residents during the morning and additional staff to help for another four hours during the afternoon shift. Also, they are discussing the possibility of allowing staff who want to work additional hours to cover these 4 hour shifts from other departments. LPA was provided with staff schedule for the month of July 2026 indicating coverage of two care staff and one medication technician for assisted living area in the morning and afternoon shift. The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6, Chapter 8), is cited on the attached LIC 9099D. Appeal Rights Given. The Department will be scheduling a meeting to discuss areas of concern and non-compliance.

SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
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)
Page: 2 of 3