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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 045000700
Report Date: 09/30/2024
Date Signed: 09/30/2024 02:02:02 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
08/15/2024 and conducted by Evaluator Farhaan Sarangi
COMPLAINT CONTROL NUMBER: 59-AS-20240815134720
FACILITY NAME:COURTYARD AT LITTLE CHICO CREEK, THEFACILITY NUMBER:
045000700
ADMINISTRATOR:MORALES, MELISSAFACILITY TYPE:
740
ADDRESS:1770 HUMBOLDT ROADTELEPHONE:
(530) 342-0707
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY:49CENSUS: 39DATE:
09/30/2024
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Administrator, Melissa AcevesTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff are not following protocals to prevent the spread of illness
INVESTIGATION FINDINGS:
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On September 30, 2024 at approximately 11:45 AM, Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced at Courtyard At Little Chico Creek, The for the purpose of conducting a subsequent complaint investigation inspection and delivering findings. LPA was greeted at the door by Administrator, Melissa Aceves, and was granted access into the facility.

During the course of the investigation, LPA reviewed the Infection Control Plan and the Staff Roster. In addition, LPA conducted staff interviews.

Complaint alleges that Staff are not following protocals to prevent the spread of illness. Based on interviews that were conducted, LPA received inconsistent statements. LPA reviewed the Infection Control Plan and emails from the Local Public Health Authority and learned that the facility was following Local Public Health guidelines as it relates to staff who test positive for COVID-19. (Report continued on LIC 9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lauren CrockerTELEPHONE: (916) 202-0832
LICENSING EVALUATOR NAME: Farhaan SarangiTELEPHONE: (916) 307-0474
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024
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-20240815134720
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: COURTYARD AT LITTLE CHICO CREEK, THE
FACILITY NUMBER: 045000700
VISIT DATE: 09/30/2024
NARRATIVE
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A finding that the complaint allegation of Staff are not following protocols to prevent the spread of illness are unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview was conducted and a copy of this was report was signed and given to the Administrator.
SUPERVISOR'S NAME: Lauren CrockerTELEPHONE: (916) 202-0832
LICENSING EVALUATOR NAME: Farhaan SarangiTELEPHONE: (916) 307-0474
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2