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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 045000603
Report Date: 06/28/2024
Date Signed: 06/28/2024 03:08:23 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
06/28/2024 and conducted by Evaluator Sarah Benson
COMPLAINT CONTROL NUMBER: 59-AS-20240628083922
FACILITY NAME:PRESTIGE ASSISTED LIVING AT OROVILLEFACILITY NUMBER:
045000603
ADMINISTRATOR:GONZALES, SONYAFACILITY TYPE:
740
ADDRESS:400 EXECUTIVE PARKWAYTELEPHONE:
(530) 534-8160
CITY:OROVILLESTATE: CAZIP CODE:
95966
CAPACITY:88CENSUS: 38DATE:
06/28/2024
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Sonya Gonzalez AdministratorTIME COMPLETED:
03:18 PM
ALLEGATION(S):
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Failure to address broken AC.
Facility maintained too hot for the residents.
INVESTIGATION FINDINGS:
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On 6-28-24 at 1:00PM Licensing Program Analyst LPA Sarah Benson, made an unannounced visit to the facility and met with Sonya Gonzalez Administrator. The purpose of this visit was to open a complaint investigation.






Continued on 9099-C

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lauren CrockerTELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Sarah BensonTELEPHONE: 530-895-5033
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2024
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 59-AS-20240628083922
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: 06/28/2024
NARRATIVE
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During the investigation Licensing Program Analyst LPA Sarah Benson and Sonya Gonzalez administrator toured the facility and memory care as well as three specific rooms in memory care. The following rooms 6,13,16 were visited. LPA Benson used a handheld thermometer to check the room temperature in room six at 78.2 degrees, room thirteen at 79.3 degrees and room sixteen at 75.1 degrees. The temperature in memory care hall thermostat read at 72 degrees as well as the handheld thermometer in LPA Benson possession.
The resident living in room thirteen has behaviors in the evening and likes to turn the heat on. Administrator reports when said resident tampers with the AC and it will sometimes lock up the AC. Administrator states that maintenance is available to fix when this happens. The staff have set room checks every 2 hours for the resident to check residents room temp. The said resident complains when the AC is turned on. Room thirteen was within regulation temperature of 79.3 degrees during today’s visit.
LPA Benson asked the administrator if there have been any complaints or problems with the AC in the last month. The administrator states no. Administrator states at times one of the assisted living residents visits the memory care area and they complain it is too hot.
LPA Benson found the building to be within regulations and at a comfortable temperature indoors with the outside temperature at 95 degrees.

No deficiencies cited. Exit interview conducted and a copy of the report was provided to Sonya Gonzalez Administrator. Although the above allegations mentioned may have happened, or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, the findings are Unsubstantiated.


SUPERVISOR'S NAME: Lauren CrockerTELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Sarah BensonTELEPHONE: 530-895-5033
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2