This is a checklist for the first week, with the Sonoma County offices that handle each step. For how these cases work, see our nursing home abuse and neglect page. Abuse outside a facility, including financial abuse, is covered on our elder abuse and neglect page.
What should we do, day by day?
- Day 1: make sure she is safe. If she is in danger or may be the victim of a crime, call 911. If she needs medical care, ask that she be seen now.
- Day 1 or 2: start a written log of what you see, with dates, times and names, and take photos where she agrees.
- Day 2: call the ombudsman. The Long-Term Care Ombudsman Program advocates for residents and can visit and help with the facility.
- Days 2 to 3: ask for her records in writing. The provider must send copies within 15 days of a written request (Health and Safety Code 123110).
- Days 3 to 5: file a complaint with the Department of Public Health's Santa Rosa office if the concern is about a licensed nursing home's care.
- Days 3 to 5: ask the administrator in writing whether the facility reported the incident and to whom.
- By day 7: decide on next steps, including a care conference, a change of doctor or a move, and whether to speak with a lawyer.
Who should we call in Sonoma County?
| Concern | Who handles it | How to reach them |
|---|---|---|
| Immediate danger, or a possible crime such as an assault | Local law enforcement | 911, or the city police or Sheriff's non-emergency line |
| Care, rights or treatment of a nursing home resident | Long-Term Care Ombudsman Program for Sonoma County, run through Senior Advocacy Services | 1129 Industrial Avenue, Suite 201, Petaluma. (707) 526-4108 |
| A complaint against a licensed nursing home | California Department of Public Health, Licensing and Certification, Santa Rosa office (also serves Marin, Napa, Mendocino, Humboldt, Lake and Del Norte) | 2170 Northpoint Parkway, Santa Rosa. (707) 576-6775, toll free (866) 784-0703. Our Santa Rosa page lists the other state and county offices in the city. |
| Abuse or neglect of an older adult living at home or elsewhere outside a care facility | Adult Protective Services, County Adult and Aging Division | (707) 565-5940, the 24-hour reporting line, or (800) 667-0404. 3725 Westwind Boulevard, Santa Rosa, and 5350 Old Redwood Highway North, Petaluma. See our Petaluma page, where the ombudsman program is also based. |
If she lives in assisted living rather than a nursing home, the licensing agency is different: state law sends reports about a residential care facility for the elderly to the State Department of Social Services (Welfare and Institutions Code 15630). The ombudsman can help you sort out which agency applies. Our guide on who regulates nursing homes and assisted living compares the two agencies and what each one changes for a claim.
What must the nursing home and its staff do?
California puts reporting duties on the facility and its staff, not only on families:
| Who | Duty | California law |
|---|---|---|
| The facility | Report every incident of alleged or suspected abuse of a resident to the Department of Public Health immediately, or within 24 hours. Failing to do so is a class B violation. | Health and Safety Code 1418.91 |
| Staff, administrators and other caregivers (mandated reporters) | For suspected abuse in a long-term care facility: a phone report to local law enforcement immediately, no later than 2 hours, and a written report within 24 hours to the ombudsman, law enforcement and the state licensing agency | Welfare and Institutions Code 15630 |
When abuse is allegedly caused by another resident with diagnosed dementia and there is no serious bodily injury, the written reports go to the ombudsman and law enforcement within 24 hours instead. Ask the administrator, in writing, whether a report was made and to whom.
California's patient's bill of rights for skilled nursing and intermediate care facilities lists rights each facility's written policies must protect, among them an adequate number of qualified staff, care to prevent bedsores, and food of the quality and quantity that meets the resident's needs under the doctor's orders (Health and Safety Code 1599.1). Those are useful measures when you describe what you are seeing.
What should we write down this week?
- Each thing you notice, with the date and time: weight loss, signs of dehydration, wounds or bedsores, bruises, soiled bedding, unanswered call lights, missed medications, falls.
- The names and shifts of the staff you speak with, and what they said.
- Photos, with her permission where she can give it, of injuries and of her room.
- Any change in her medications, especially new sedating or antipsychotic drugs. For a skilled nursing facility, the prescribing doctor must get her informed consent and, if she agrees, try to tell the family member named in her record within 48 hours (Health and Safety Code 1418.9).
- Every call, meeting and letter with the facility, and the date of any report you make.
How do we get her records?
A patient, or a patient's personal representative, is entitled to copies of the patient's records after a written request, and the provider must send them within 15 days after receiving it (Health and Safety Code 123110). Ask for the full chart: care plan, nursing notes, medication records, weight and intake charts, and any incident reports involving her. Keep a copy of your request.
When does neglect become a legal claim?
California's Elder Abuse and Dependent Adult Civil Protection Act protects people 65 and older (Welfare and Institutions Code 15610.27), and adults 18 to 64 with physical or mental limitations, including anyone admitted as an inpatient to a 24-hour health facility (Welfare and Institutions Code 15610.23). It defines neglect as the negligent failure of a caregiver to use the care a reasonable person in a like position would use, including failure to help with personal hygiene, food or clothing, failure to provide medical care, failure to protect from health and safety hazards, and failure to prevent malnutrition or dehydration (Welfare and Institutions Code 15610.57).
When neglect is proven with recklessness, oppression, fraud or malice, the Act adds remedies a regular injury claim does not have. Our guide on what California's Elder Abuse Act adds to a claim explains them.
A separate law lets a current or former resident of a skilled nursing facility, or their legal or personal representative or successor in interest, sue the facility's licensee for violating the resident's rights under state or federal law, with statutory damages of up to $500 for each violation that occurred on or after March 1, 2021, plus costs and attorney's fees, as the statute provides (Health and Safety Code 1430(b)). An agreement to waive that right is void. Our guide to residents' rights claims against a nursing home explains how that claim works.
Should we move her?
That is a family decision, and her safety comes first. Before a move, request her records and photograph her condition and room, because both are harder to document afterward. The ombudsman can explain her rights during a transfer or discharge.
What changes the answer?
She lives in assisted living, not a nursing home. Reports about a residential care facility for the elderly go to the State Department of Social Services rather than the Department of Public Health (Welfare and Institutions Code 15630), and the residents' rights lawsuit in Health and Safety Code 1430(b) is written for skilled nursing and intermediate care facilities.
She lives in Marin County. The Marin County Long-Term Care Ombudsman Program is at 10 North San Pedro Road, Suite 1024A, San Rafael, (415) 473-7446, and Marin's Adult Protective Services hotline is 415-473-2774. See our page on personal injury cases in Marin County.
Another resident hurt her. When the other resident has diagnosed dementia and there is no serious bodily injury, the staff's written reports go to the ombudsman and law enforcement (Welfare and Institutions Code 15630). The facility's duty to protect her from health and safety hazards is still part of the neglect definition (Welfare and Institutions Code 15610.57).
The facility is run by a public entity. A written claim to that entity is due within six months (Government Code 911.2); see how to file an injury claim against a city, county or the State.
Money is missing. Financial abuse of an elder has its own four-year rule from discovery (Welfare and Institutions Code 15657.7).
She has died. Her estate's claims and the family's claims follow different rules; see what a family can recover for pain before death after 2026.
What could this look like? An example
For example, imagine a daughter who visits her 84-year-old mother in a Santa Rosa skilled nursing facility and notices she has lost weight, her water pitcher is out of reach, and she has a wound on her heel the staff did not mention. The daughter photographs the room and the wound with her mother's agreement and writes down the date and the name of the nurse on duty.
The next day she calls the ombudsman program in Petaluma, which arranges a visit, and she sends the administrator a written request for the full chart and asks whether any incident was reported. On day four she files a complaint with the Department of Public Health's Santa Rosa office. When the chart arrives, the weight and intake records show a steady decline over six weeks, which she brings to a care conference and to a lawyer. This example is made up to show the first-week steps; it predicts nothing about a real case.
What mistakes do families make in the first week?
- Raising concerns only by phone, with nothing in writing.
- Waiting for the next care conference instead of calling the ombudsman now.
- Asking for "her records" without listing the parts of the chart they need.
- Moving her before documenting her condition and getting the records.
- Assuming the facility reported the problem without asking.
- Signing new admission or arbitration paperwork during the crisis without reading it.
Are there deadlines?
Yes. A lawsuit for injury generally must be filed within two years (Code of Civil Procedure 335.1), and claims for financial abuse of an elder have a four-year rule (Welfare and Institutions Code 15657.7). If the facility is run by a county or other public entity, a written claim is due within six months. See California personal injury deadlines. Our article on legal support for seniors lists other resources. The county offices are listed on our Sonoma County page.
Frequently asked questions
Will reporting the facility make things worse for her?
The ombudsman program exists to advocate for residents and can help you raise concerns. Write down any change in how she is treated after a report and tell the ombudsman.
Can I get her records if she cannot sign?
A patient's personal representative is entitled to the records on written request (Health and Safety Code 123110). Bring the document that shows you are her representative.
Does the facility have to tell us about new medications?
For antipsychotic drugs in a skilled nursing facility, the prescriber must get her informed consent and, if she agrees, try to notify the family member named in her record within 48 hours (Health and Safety Code 1418.9).
Is a bedsore always neglect?
Not always, but residents have the right to care that prevents bedsores (Health and Safety Code 1599.1), and failure to provide medical care or protect from health hazards is neglect under the Act (Welfare and Institutions Code 15610.57). Our guide on bedsores and nursing home neglect explains what the rules require and which records show it.
Who investigates a complaint against a nursing home?
The Department of Public Health's Licensing and Certification program, through its district offices; Sonoma County is served by the Santa Rosa office.
What if she is under 65?
The Act also protects adults 18 to 64 with physical or mental limitations, including anyone admitted as an inpatient to a 24-hour health facility (Welfare and Institutions Code 15610.23).
If you believe a loved one is being neglected or abused in a Sonoma County nursing home, contact Young Law Group today at (707) 343-0556 or through our contact page to schedule your free consultation and learn how we can help.
Sources
- California Department of Aging: services in Sonoma County (Long-Term Care Ombudsman)
- California Department of Public Health: Licensing and Certification district offices
- County of Sonoma: Adult and Aging Division (Adult Protective Services)
- County of Sonoma: Adult Protective Services (24-hour reporting lines)
- Welfare and Institutions Code section 15630 (mandated reporters and where reports go)
- Health and Safety Code section 1418.91 (facility reports within 24 hours)
- Health and Safety Code section 1418.9 (antipsychotic medication consent and family notice)
- Health and Safety Code section 123110 (copies of medical records)
- Welfare and Institutions Code section 15610.27 (who is an elder)
- Welfare and Institutions Code section 15610.23 (who is a dependent adult)
- Welfare and Institutions Code section 15610.57 (what neglect is)
- Code of Civil Procedure section 335.1 (two years for injury)
- Welfare and Institutions Code section 15657.7 (financial abuse deadline)
- Health and Safety Code section 1599.1 (patient's bill of rights in skilled nursing and intermediate care facilities)
- Health and Safety Code section 1430 (residents' rights lawsuits)
- Government Code section 911.2 (six-month claim to a public entity)
- County of Marin: report elder abuse or neglect (Adult Protective Services)
- California Department of Aging: services in Marin County (Long-Term Care Ombudsman)
