Cogir of Sonoma

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by Administrator Rafael "Omar" Mendoza: Administrator Certificate 7027912740 expires 6/19/26. At approximately 10:00am LPA toured Assisted Living rooms. LPA observed pull cords and grab bars present in resident bathrooms. Facility has Independent Living (IL) and Assisted Living (AL) residents. Facility does not offer Memory Care. LPA and Admin toured selected AL resident rooms: #108, #111, #115, #202, and #205. Administrator then joined LPA and toured the rest of the building and grounds. The facility was found to be clean and at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered. Freezer and refrigerator temperature logs present. All temperatures observed are in compliance with regulation. LPA observed hot water sign present in dish washing area. Kitchen utilizes hot bar bain marie, all foods properly stored and covered within the bain marie. Pantry item bins all properly sealed and labeled. Water temperature in sink accessible to residents in care measured at 118.6 degrees F in room #108, 116.3 degrees F in room #111, 117.7 degrees F in room #115, 115.7 degrees F in room #202, and 117 degrees F in room #205 degrees F which are all within the allowable range of 105 to 120 degrees F. LPA measured water temperature in movie room, hot water was turned off. Administrator immediately called maintenance to address the issue of it being turned off. Continued on 809C... Continued from 809... Fire extinguishers were last inspected 1/9/25, but showing as fully charged. Per Administrator, vendor servicing fire extinguishers is set for next week. However, he requested for them to come out earlier next year in order to avoid being slightly over on the annual servicing. Smoke/Carbon Monoxide detectors located throughout the facility are hardwired, last serviced by vendor on 2/13/25. Sprinklers throughout facility are serviced by vendor, last date of service 6/13/25. Facility’s last quarterly disaster drill was conducted October 2025. LPA discussed with Administrator making sure disaster drills are conducted quarterly. Facility equipped with elevators, all elevator permits are active expiring 7/31/26. At approximately 12:30pm LPA conducted a review of eight [8] resident records. All documentation present. No deficiencies. At approximately 2:30pm LPA conducted review of seven [7} staff records. All documentation present. No deficiencies. At approximately 3:30pm LPA and Health and Wellness Director (HWD) conducted a spot check of medication and medication records. Medication is centrally stored in a locked room. LPA and HWD observed two medication errors for resident (R1). Start date for Levothyroxine 1/1/26, R1 is to receive one [1] tab per day; however only one [1] tablet remaining in 31 tab bubble pack, so bubble pack missing one dose. Start date for Florastor 1/16/26, R1 is to receive 2 capsules per day; however 5 capsules remain in 31 capsule bubble pack, so there is one [1] capsule too many (deficiency cited, see 809D). LPA and Administrator reviewed facility's Infection Control Plan and Emergency Disaster plan. Administrator provided LPA with updated copy. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Administrator. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and a copy of this report was given.the state’s words, verbatim · CDSS document, Jan 29, 2026

The state marks this report as 7 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a Case Management and was greeted by concierge. LPA met with Rose Lazzarotto, Business Office Manger (BOM). Administrator Omar Mendoza was available by phone. On 6/16/25, facility submitted incident report indicating on 6/7/25 resident (R1) exited the community unassisted. Facility is located close to boutique hotel Pueblo Inn. A staff member of Pueblo Inn called the facility to alert them that R1 was at their property. Administrator sent staff S1 over to accompany R1 back to the facility. At approximately 11:00am S1 found R1 and accompanied them back to the facility. Health and Wellness Director (HWD), Norma Alvarez immediately notified R1’s family member and Primary Care Physician of elopement. Admin then discussed with family the need for a companion due to new exiting behavior exhibited. Companion was provided to R1 by family. However, Admin felt that transfer to a facility with Memory Care could be a positive intervention to her benefit, as risk of exiting behavior may continue in Assisted Living. So, R1 was moved to a sister community's Memory Care unit. R1 left facility on 6/30/25. Incident report indicates R1 has diagnosis of dementia. LPA reviewed R1's physician report and Care plan. Physician's report indicates that R1 did not have a history of disorientation, unsafe wandering, elopement, or sundowning behavior. However, physician's report indicates that R1 is not allowed to leave the facility unsupervised. LPA reviewed Care plan, Care plan indicates that R1 had mild neurocognitive impairment, but had no impairment with vision, hearing, communication, ambulating, or history wandering/elopement. When R1 was found by S1, R1 seemed anxious and stating they “wanted to go somewhere,” but care plan indicated that resident did not have current or history of anxiety. Admin advised LPA that in 6/3/25 R1 was moved from Independent Living to Assisted Living, as physician's report and care plan both indicated resident did not have history Continued on 809C... Continued from 809... of wandering behavior, sundowning behavior, or elopement, so resident not identified with risk of elopement. Admin advised LPA that he believes incident of elopement was not the result of a lack of staff supervision, but rather perhaps a progression of their dementia. Additionally, Admin disagrees with physician report assessment of R1 not being able to leave the facility unassisted as R1's physician report also indicates that R1 does not experience disorientation, lack of hazard awareness, lack of impulse control, unsafe wandering, elopement, sundowning behavior, expressions of frustration, hallucinations, or any other history of behavioral expressions that would make R1 at risk for elopement. LPA and Admin discussed thoroughly reviewing all residents' physician reports and if any discrepancies are found, Admin to immediately address discrepancies and get revised physician's report, if needed. Admin understands and agrees. No deficiency cited. Exit interview conducted with Administrator via telephone and a copy of this report was given to BOM.the state’s words, verbatim · CDSS document, Jul 23, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by Administrator Rafael "Omar" Mendoza: Administrator Certificate 7027912740 expires 6/19/26. At approximately 9:30am LPA and Admin toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered. Facility has Independent Living (IL) and Assisted Living (AL) residents. Facility does not offer Memory Care. LPA and Admin toured selected AL resident rooms: #101, #103, #114, and #208 . All bedroom bathrooms were equipped with an emergency pull cord and grab bars. Water temperature in sink accessible to residents in care measured at 114.3 in rooms #101 and #103, 113.5 in room #114, and 121.2 in room #208 degrees F which are within the allowable range of 105 to 120 degrees F, except for in room #208 which is not within the the allowable range. Admin advised LPA that facility has 8 water heaters. LPA and Admin agreed to lower the temperature of the water heater just slightly in order to ensure water temperature stays within regulation. Fire extinguishers were last inspected 1/9/25. Smoke/Carbon Monoxide detectors located throughout the facility are hardwired, last serviced by vendor on 8/26/24. Facility’s last quarterly disaster drill was conducted 12/13/24. Facility equipped with elevators, last service date 3/15/24. At approximately 11:30am LPA conducted a review of 5 resident records. All documentation present. No deficiencies. Continued on 809C... Continued from 809... At approximately 12:45pm LPA conducted review of 5 staff records. All documentation present. No deficiencies At approximately 2:00pm LPA and Health and Wellness Director (HWD) conducted a spot check of medication and medication records. Medication is centrally stored in a locked room. No deficiencies LPA reviewed facility's Infection Control Plan and Emergency Disaster plan. No new updates. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308- Designation of Responsibility No deficiencies cited. Exit interview conducted with Administrator and copy of this report was given.the state’s words, verbatim · CDSS document, Jan 13, 2025

The state marks this report as 5 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to continue the required Annual inspection and was greeted by Rafael (Omar) Mendoza, Administrator. Facility currently has three [3] residents on hospice which is allowable per the facility's Hospice Waiver. Hospice plans for all three [3] residents were available, LPA reviewed all three [3] plans. At approximately 9:30am LPA conducted a review of five [5] staff files. LPA observed that staff (S1) did not have a clear TB or chest xray present in file. Additionally S1's Health Screen is dated more than 6 months prior to employment. S1 employed in 2020, Health Screen dated 2018. S2, S3, and S4 had indication that TB skin test was performed but no results in file and chest xray not present. Per Title 22 regulation 87411 Personnel Requirements - General (f) All personnel, including the licensee and administrator, shall be in good health...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 (deficiency cited, see 809D). At approximately 12:15pm LPA, Med Tech (MT) and Health and Wellness Director (HWD) conducted a spot check of medication and medication records. Medication is centrally stored in a locked medication room on the first floor and in med carts stored in the med room. The room contains a refrigerator for refrigerated medications. Narcotics are double locked in the medication carts. Facility currently manages resident medications using EMARs and PCC system. LPA and HWD accompanied MT during afternoon med pass. LPA observed that medications are live poured and med cart remains in control of MT while MT is administering medications to residents. Per LPA, MT, and HWD observation and record review resident (R1) had incorrect expiration and fill dates entered on CSML for their Levothyroxine and Atorvastation prescriptions; resident (R3) had incorrect expiration date entered on CSML for their Metoprolol prescription. Continued on 809C... Continued from 809... Per Title 22 regulation 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:... (D) The date filled... (deficiency cited, see 809D). At approximately 2:00pm LPA reviewed five [5] resident files. LPA observed R2 did not have a TB screen or results in their file, chest xray present but does not mention negative TB or evidence (or lack) of TB. LPA verified with Admin R2 does not have TB screen. Per Title 22 regulation 87458 Medical Assessment (b) The medical assessment shall include, but not be limited to:(1) A physical examination of the resident indicating the physician's primary diagnosis and secondary diagnosis, if any and results of an examination for communicable tuberculosis, other contagious/infectious diseases or other medical conditions which would preclude care of the person by the facility (deficiency cited, see 809). Rafael (Omar) Mendoza Administrator Certificate 6039775740 expires 6/19/2024. All fees are current as of this time, fee due in February. LPA gave Admin PIN to make online fee payment. LPA and Admin discussed facility's Infection Control Plan. LPA reviewed Infection Control Plan. Per Admin no new updates. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308- Designation of Responsibility Evidence of Liability Insurance Current Lease Transportation Procedures Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Licensee. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and a copy of this report was given.the state’s words, verbatim · CDSS document, Jan 26, 2024

The state marks this report as 7 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by Rafael (Omar) Mendoza, Administrator. Facility currently has 3 residents on hospice which is allowable per the facility's Hospice Waiver. Facility contact information was reviewed. At approximately 10:00am LPA and Admin toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered and labeled. All bedrooms were equipped with lighting, night stand, and chest of drawers. All bedrooms were clean and in good repair. Extra hygiene products and linens were available. Resident bathrooms had required bath mats and grab bars. Water temperature in sink(s) accessible to residents in care measured at 113.2 and 117.2 degrees F, respectively which is within the allowable range of 105 to 120 degrees F. Fire extinguishers were last inspected 2/10/2023. Facility's fire system is maintained by a vendor and the most recent test/service of the system was conducted 2/23/2023. Exit doors have an auditory alert system that was functional at time of inspection. Facility’s last quarterly disaster drill was conducted on 11/29/2023. Facility has a backup generator for use during a power outage. At approximately 12:30pm LPA conducted resident interviews. At approximately 2:30pm LPA conducted Staff interviews. No deficiencies cited during today's visit.LPA unable to complete annual inspection today, will return at a later date to complete. Any observed deficiencies will be addressed on return visit. Exit interview was conducted with Administrator and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jan 24, 2024

The state marks this report as 7 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.