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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 045000644
Report Date: 12/07/2023
Date Signed: 12/07/2023 11:17:03 AM

Unfounded


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
11/06/2023 and conducted by Evaluator Jaynae Boyles
COMPLAINT CONTROL NUMBER: 59-AS-20231106081750
FACILITY NAME:PRESTIGE ASSISTED LIVING AT CHICOFACILITY NUMBER:
045000644
ADMINISTRATOR:CORREA, GEORGEDINOFACILITY TYPE:
740
ADDRESS:1351 E. LASSEN AVENUETELEPHONE:
(530) 899-0814
CITY:CHICOSTATE: CAZIP CODE:
95973
CAPACITY:79CENSUS: 61DATE:
12/07/2023
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Administrator- Scott Blow TIME COMPLETED:
11:20 AM
ALLEGATION(S):
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Licensee does not ensure call signal system is in good repair.
Staff do not ensure residents care needs are being met in a timely manner.
INVESTIGATION FINDINGS:
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12/07/2023 Licensing Program Analyst (LPA) Jaynae Boyles made an unannounced visit to the facility and met with Executive Director Scott Blow. The purpose of this visit is to deliver the results of a complaint investigation.
During the interview process, the executive director and three residents were interviewed.
During the investigation, it was reported by the Administrator and residents that the signal system was in working order. It was discovered that not all residents were given a pendent. However, all residents have access to a signal system within their unit. There are two wall mounted signal mechanisms that can be taken off the wall to become mobile. All residents have access to a signal system.
This agency has investigated the complaint alleging the facility signal system is in disrepair and not meeting the needs of the residents. We have found the complaint was UNFOUNDED, meaning that the allegation is false, could not have happened, and/or is without a reasonable basis.
An exit interview was conducted. A copy of the report was provided to the executive director, Scott Blow.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Lauren CrockerTELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Jaynae BoylesTELEPHONE: (916) 208-6251
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
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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