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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019200873
Report Date: 07/14/2022
Date Signed: 07/14/2022 04:56:56 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/02/2022 and conducted by Evaluator Catherine Lin
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20220202132020
FACILITY NAME:POINT AT ROCKRIDGE, THEFACILITY NUMBER:
019200873
ADMINISTRATOR:SAVOIE, DEBORAHFACILITY TYPE:
740
ADDRESS:4500 GILBERT STREETTELEPHONE:
(510) 658-9266
CITY:OAKLANDSTATE: CAZIP CODE:
94611
CAPACITY:186CENSUS: 131DATE:
07/14/2022
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Paul Willams, Building Services DirectorTIME COMPLETED:
05:10 PM
ALLEGATION(S):
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Staff yell at residents.
Staff humiliate residents.
Staff force feed residents to finish meals.
Staff did not follow resident's dietary needs.
Staff display aggressive behavior towards residents.
Resident sustained injuries while in care.
INVESTIGATION FINDINGS:
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On 7/14/22 at 2:00 pm, Licensing Program Analyst (LPA) Catherine Lin conducted an unannounced subsequent complaint investigation regarding the above allegations and delivered investigation findings. LPA explained the purpose of the visit with Building Services Director.

The Department has investigated the above allegations and per record review and interviews found that staff yell at residents, staff humiliate residents, staff force feed residents to finish meals, staff did not follow resident's dietary needs, staff display aggressive hehavior towards residents were denied by 9 staff and 1 witness.

Based on record review and interview, the Department found that R1 had a witnessed fall due to losing balance while working with walker from the dining room on 7/30/2021, R1 had three skin tears on her left arm, Med-Tech S2 did wound care and informed responsible parties, R1 was seen primary care physician on 7/31/2021.

Continue LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Bennett FongTELEPHONE: (510) -62-2621
LICENSING EVALUATOR NAME: Catherine LinTELEPHONE: 510-622-2053
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
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 15-AS-20220202132020
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: POINT AT ROCKRIDGE, THE
FACILITY NUMBER: 019200873
VISIT DATE: 07/14/2022
NARRATIVE
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Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are unsubstantiated.

No deficiency cited. Exit interview conducted and a copy of this report provided to Building Services Director.

SUPERVISOR'S NAME: Bennett FongTELEPHONE: (510) -62-2621
LICENSING EVALUATOR NAME: Catherine LinTELEPHONE: 510-622-2053
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2