045000644-6-25-2021-25-AS-KMKY-C4EULE-20210628154035

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 045000644
Report Date: 06/25/2021
Date Signed: 06/25/2021 03:11:42 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/21/2020 and conducted by Evaluator Misty Valencia

PUBLIC

COMPLAINT CONTROL NUMBER: 25-AS-20201021132234

FACILITY NAME:	PRESTIGE ASSISTED LIVING AT CHICO		FACILITY NUMBER:	045000644
ADMINISTRATOR:	GREER, ANTHONY		FACILITY TYPE:	740
ADDRESS:	1351 E. LASSEN AVENUE		TELEPHONE:	(530) 899-0814
CITY:	CHICO	STATE: CA	ZIP CODE:	95973
CAPACITY:	79	CENSUS: 60	DATE:	06/25/2021
		UNANNOUNCED	TIME BEGAN:	04:00 PM
MET WITH:	Executive Director (ED) Brandy Stahl		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff failed to ensure residents are properly fed while in care
Facility is in disrepair

INVESTIGATION FINDINGS:

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On 06/25/2021, Licensing Program Analyst (LPA) Misty Valencia conducted an unannounced complaint investigation visit regarding the above allegations and met with Executive Director (ED) Brandy Stahl. Prior to initiating the complaint visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; contacted Administrator and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA was screened by front desk receptionist.

continued on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kevin Mknelly	TELEPHONE: (209) -81-1925
LICENSING EVALUATOR NAME: Misty Valencia	TELEPHONE: (530) 895-5820
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021

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 25-AS-20201021132234

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: PRESTIGE ASSISTED LIVING AT CHICO	FACILITY NUMBER: 045000644
	VISIT DATE: 06/25/2021

NARRATIVE

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Staff failed to ensure residents are properly fed while in care
LPA investigated the allegation, Staff failed to ensure residents are properly fed while in care to be unsubstantiated. LPA toured the facility and the kitchen area. LPA observed 2-day perishable and 7-day non-perishable amount of food. LPA observed fresh fruits, vegetables, dairy items, eggs, meats, canned goods, snacks, and boxed rice and pasta. LPA interviewed 8 of 8 residents in care in which they stated they receive 3 meals a day with other options available if it is disliked item and snack items. All residents state staff do provide sufficient amount of food with fresh fruits and vegetables and are satisfied with their food options. LPA interviewed 6 of 6 staff members in which they stated they provide 3 meals a day and snacks to the residents and have not heard that the residents were unsatisfied. As a result of this investigation, LPA finds the allegations that Staff failed to ensure residents are properly fed while in care UNSUBSTANTIATED. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Facility is in disrepair

LPA investigated the allegation, Facility is in disrepair to be unsubstantiated. LPA toured the facility and during the visit, LPA Valencia walked through six resident rooms to check for unsanitary conditions and dirty floors. Rooms were in standard or fair condition, i.e. floors and carpets were clean, counters and nightstands were wiped down, and minimal garbage in the trash cans. LPA toured the dining area, where the carpet was stained, but there is no trip or safety hazards and there is no odors. LPA interviewed 6 of 6 resident who all reported they have no dirty or unsanitary issues in the facility. LPA interview 6 of 6 staff members who all agreed that the carpet in the dining area needs to be replace, but other than that there are no issues. ED reported that there is currently a bid to get the carpet replace in the common areas. As a result of this investigation, LPA finds the allegations that facility is in disrepair, UNSUBSTANTIATED. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

There were no citations issued during today's visit, copy of report was given. An exit interview was conducted

SUPERVISOR'S NAME: Kevin Mknelly	TELEPHONE: (209) -81-1925
LICENSING EVALUATOR NAME: Misty Valencia	TELEPHONE: (530) 895-5820
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021

LIC9099 (FAS) - (06/04)

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