045001959-8-12-2024-59-AS-KHOS-D8AR8T-20240819124827

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 045001959
Report Date: 08/12/2024
Date Signed: 08/12/2024 01:39:42 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
05/13/2024 and conducted by Evaluator Jaynae Boyles

COMPLAINT CONTROL NUMBER: 59-AS-20240513093604

FACILITY NAME:	WINDCHIME OF CHICO		FACILITY NUMBER:	045001959
ADMINISTRATOR:	FENNEL, LISA		FACILITY TYPE:	740
ADDRESS:	855 BRUCE RD		TELEPHONE:	(530) 566-1800
CITY:	CHICO	STATE: CA	ZIP CODE:	95928
CAPACITY:	120	CENSUS: 48	DATE:	08/12/2024
		UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Executive Director- Mark Morris		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Licensee does not ensure that the residents thermostat is kept in working condition.
Facility staff did not seek timely medical attention for residents pressure injuries.
Facility staff leave residents in soiled bedding.

INVESTIGATION FINDINGS:

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On 08/12/2024 Licensing Program Analyst Jaynae Boyles made an unannounced visit to the facility and met with administrator Mark Morris. The purpose of this visit was to deliver the results of a complaint investigation.

Based on interviews and observation the allegations are unsubstantiated.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are UNSUBSTANTIATED.
An exit interview was conducted. A copy of the report was provided to administrator.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lauren Crocker	TELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Jaynae Boyles	TELEPHONE: (916) 208-6251
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024

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-20240513093604

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: WINDCHIME OF CHICO	FACILITY NUMBER: 045001959
	VISIT DATE: 08/12/2024

NARRATIVE

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LPA investigated, “Licensee does not ensure that the residents’ thermostat is kept in working condition”. LPA arrived to the facility two times unannounced when the temperature outside exceeded 100 degrees, and the temperature within the building was between 72-75 degrees. The administrator reported that two of the units were broken however, the facility rented portable AC units to ensure a consistent temperature.

LPA investigated, “Facility staff did not seek timely medical attention for residents pressure injuries.” Of the staff interviewed, all reported that they did not manage pressure injuries as these services is referred to home health or hospice. All staff reported that if there is an indication of a pressure injury the staff will inform the resident care coordinator to assess and refer for home health services. LPA contacted the residents family mentioned in the complaint, who reported that the resident did not have a pressure injury while at the facility.

LPA investigated, “Facility staff leave residents in soiled bedding.” All staff reported that they check all residents every two hours or as needed for changing of briefs. All staff reported that they discuss at shift change when residents were last changed and if there are any needs of the residents pending.

SUPERVISOR'S NAME: Lauren Crocker	TELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Jaynae Boyles	TELEPHONE: (916) 208-6251
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024

LIC9099 (FAS) - (06/04)

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