045000603-9-7-2023-59-AS-KHOS-CVLJRN-20230912071702

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 045000603
Report Date: 09/07/2023
Date Signed: 09/07/2023 12:50:22 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/13/2023 and conducted by Evaluator Rebecca Knight

COMPLAINT CONTROL NUMBER: 59-AS-20230613115414

FACILITY NAME:	PRESTIGE ASSISTED LIVING AT OROVILLE		FACILITY NUMBER:	045000603
ADMINISTRATOR:	GEORGE DINO CORREA		FACILITY TYPE:	740
ADDRESS:	400 EXECUTIVE PARKWAY		TELEPHONE:	(530) 534-8160
CITY:	OROVILLE	STATE: CA	ZIP CODE:	95966
CAPACITY:	88	CENSUS: 34	DATE:	09/07/2023
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Sonya Gonzalez - Executuve Director		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Insufficient number of staff endangering residents’ safety. - UNSUBSTANTIATED

INVESTIGATION FINDINGS:

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09/07/2023 12:30 PM Licensing Program Analysts (LPAs) Rebecca Knight and Jaynae Boyles made an unannounced visit to the facility and met with Executive Director Sonya Gonzalez. The purpose of this visit was to deliver complaint investigation results.

During the course of the investigation LPA interviewed the Executive Director and 6 staff. LPA reviewed the following documents: staff list with telephone numbers, resident list, Staffing schedule, Physician’s report, Admission Agreement, care plan for 4 residents.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lauren Crocker	TELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Rebecca Knight	TELEPHONE: (530) 356-2841
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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 59-AS-20230613115414

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: PRESTIGE ASSISTED LIVING AT OROVILLE	FACILITY NUMBER: 045000603
	VISIT DATE: 09/07/2023

NARRATIVE

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Insufficient number of staff endangering residents’ safety.

It was reported that the facility had cut back on staffing which left 1 staff to care for more than 20 residents including residents who require a 2 person assist.

The facility is licensed for a capacity of 88 residents and had a census of 35 residents on the day that the complaint was opened.

LPA reviewed staffing schedules for the months of June 18 through July 29, 2023 and the staff schedules showed that 1 Med Tech and 1 care staff were scheduled on duty for each shift on both the assisted living and memory care sections of the building. LPA reviewed 5 resident care plans and 4 of 5 of the residents reviewed required 2 person assistance with activities of daily living as needed. LPA reviewed incident reports for falls that were submitted by the facility for the months of March 2023 through August 2023. There was not a significant increase in reported falls during that time period.

LPA interviewed different staff 2 months apart. In June 2023 staff stated between 1 and 5 residents were a 2 person assist, 2 months later staff stated there were between 6 to 10 residents who required a 2 person assist. 5 of 6 staff stated there is 1 Med Tech and 1 care giver on each side of the facility (assisted living and memory care). 6 of 6 staff stated the facility has cut back on staff hours. 2 of 6 staff stated the facility cut back on staff hours by increasing the lunch breaks and changing the shift start time by 15 minutes later than previous. 5 of 6 staff stated they do not think there are enough staff on each shift to ensure the safety of the residents. 5 of 6 staff stated they do not think there are enough staff on each shift to provide the necessary care for the residents. No staff provided specific examples of resident care being adversely affected or residents being endangered as a result of the staffing levels.

Continued on LIC9099-C

SUPERVISOR'S NAME: Lauren Crocker	TELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Rebecca Knight	TELEPHONE: (530) 356-2841
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 59-AS-20230613115414

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: PRESTIGE ASSISTED LIVING AT OROVILLE	FACILITY NUMBER: 045000603
	VISIT DATE: 09/07/2023

NARRATIVE

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In June 2023 the administrator stated the facility was on a low census plan. When the new administration started the facility was 3 employees over per their budget. At that time there were 10 employees on workman’s comp, or personal injury that the facility was scheduling, but these employees were very limited as to the job duties they could perform.

At the time of the interview the facility had 12 residents in the memory care unit and were staffing 1 med tech, 1 to 2 care staff, and the director in that unit. The facility had 22 residents in the assisted living section of the facility and were staffing 1 med tech and 2 PCA’s to accommodate residents who required 2 person lifts. In addition, the resident services director was on the floor. The med tech was also serving as care staff due to low census. At that time the facility stopped accommodating the extra staff because they were very limited to the job duties they could perform due to injuries.

It was determined that the new administration did reduce the staffing levels due to low resident census. There has not been a substantial increase in falls at the facility from March 2023 to present which could be an indicator of insufficient staffing and thus indicate that residents are at a higher risk of injury. This allegation is unsubstantiated.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred, and the findings are UNSUBSTANTIATED.

An exit interview was conducted. A copy of the report was provided to Executive Director Sonya Gonzalez.

SUPERVISOR'S NAME: Lauren Crocker	TELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Rebecca Knight	TELEPHONE: (530) 356-2841
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

LIC9099 (FAS) - (06/04)

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