045000603-4-23-2024-59-AS-LMUZ-D59PGK-20240514111827

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 045000603
Report Date: 04/23/2024
Date Signed: 04/23/2024 09:54:28 AM

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
03/19/2024 and conducted by Evaluator Donna Gurriere

COMPLAINT CONTROL NUMBER: 59-AS-20240319134311

FACILITY NAME:	PRESTIGE ASSISTED LIVING AT OROVILLE		FACILITY NUMBER:	045000603
ADMINISTRATOR:	GONZALES, SONYA		FACILITY TYPE:	740
ADDRESS:	400 EXECUTIVE PARKWAY		TELEPHONE:	(530) 534-8160
CITY:	OROVILLE	STATE: CA	ZIP CODE:	95966
CAPACITY:	88	CENSUS: 45	DATE:	04/23/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	SONYA GONZALES		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Staff are retaliating against residents for making complaints.

INVESTIGATION FINDINGS:

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On 04/23/24 Donna Gurriere, Licensing Program Analyst (LPA) arrived at the facility unannounced to deliver final findings regarding a complaint that was received on 03/19/24. LPA Gurriere met with Sonya Gonzales, Administrator, and explained the purpose of the visit.

Staff are retaliating against residents for making complaints.

During the interview process, documents were obtained to include Physician’s Reports, Admission Agreements, a letter from California Advocates for Nursing Home Reform (CANHR), employee names and telephone numbers, resident names, and resident power of attorney names and telephone numbers.

continued

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lauren Crocker	TELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Donna Gurriere	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 04/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 59-AS-20240319134311

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: 04/23/2024

NARRATIVE

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During the investigation process, the administrator and family members were interviewed. The residents were observed; however, were not interviewed due to their cognitive impairment. In addition, LPA Gurriere toured the apartments of the memory care residents.

The allegation is that “Staff are retaliating against residents for making complaints.” It is noted that residents did not make complaints. It was reported that the family members voiced concerns that the administrator removed video cameras from two resident rooms. The administrator reported that she did take cameras out of resident rooms, as the facility corporation did not have a policy in place when cameras were installed. The administrator advised that she removed the cameras as a directive from the corporation.

On 04/15/24 a complaint investigation was conducted and addressed the issues surrounding cameras allowed in resident rooms; allegation was Substantiated. See report for additional details. It has been determined that staff did not retaliate against residents for making complaints.

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

SUPERVISOR'S NAME: Lauren Crocker	TELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Donna Gurriere	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 04/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024

LIC9099 (FAS) - (06/04)

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