045000603-4-23-2024-59-AS-LMUZ-D59PG9-20240514111757

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 045000603
Report Date: 04/23/2024
Date Signed: 04/23/2024 09:52:56 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
02/08/2024 and conducted by Evaluator Donna Gurriere

COMPLAINT CONTROL NUMBER: 59-AS-20240208131856

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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Illegal eviction.
Facility is not meeting resident’s hygiene needs.

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 02/08/24. LPA Gurriere met with Sonya Gonzales, Administrator, and explained the purpose of the visit.

Illegal eviction.

During the interview process, documents were obtained to include Physician’s Report, Admission Agreement, 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-20240208131856

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, five staff persons, and the resident’s power of attorney were interviewed. The resident was observed; however, was not interviewed due to his cognitive impairment.

It was reported that the administrator had a conversation with the resident’s (Resident 1) power of attorney. The administrator stated that she wanted to ensure that the resident’s power of attorney was satisfied with the care and supervision that was provided to the resident. The power of attorney indicated that she wasn’t sure as to why the administrator was asking about being satisfied with the resident’s care. The administrator reported that she thought that the family was unhappy with the resident's care. The power of attorney stated she was satisfied with the care. The administrator did not serve the power of attorney with a formal eviction letter; thus, there was not an illegal eviction.

Facility is not meeting resident’s hygiene needs.

During the investigation process, the administrator, five staff persons, and the resident’s power of attorney were interviewed. The resident was observed; however, was not interviewed due to his cognitive impairment. The resident was sitting at a table doing an activity with a staff person. The resident appeared to be clean and dressed; staff indicated he had showered the day before.

It was reported that the resident generally showers daily except for when he refuses to shower. Staff indicated that the resident has the right to refuse showers, which they stated he does approximately two times per week. All interviewed indicated that they believe that the resident showers regularly and that his hygiene needs are being met.

Although the above allegations mentioned may have happened, or is valid, there is not a preponderance of evidence to prove that the alleged violations 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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