045002775-10-23-2023-59-AS-KHOS-CWWFYZ-20231024045509

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 045002775
Report Date: 10/10/2023
Date Signed: 10/23/2023 09:39:26 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
05/01/2023 and conducted by Evaluator Donna Gurriere

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20230501082310

FACILITY NAME:	ROSELEAF GARDENS		FACILITY NUMBER:	045002775
ADMINISTRATOR:	SMITH, AUDRE		FACILITY TYPE:	740
ADDRESS:	2770 SIERRA LADERA		TELEPHONE:	(530) 895-0800
CITY:	CHICO	STATE: CA	ZIP CODE:	95928
CAPACITY:	56	CENSUS: 38	DATE:	10/10/2023
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	STACEY BAXTER		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Facility is operating without an Administrator.

INVESTIGATION FINDINGS:

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On 10/10/23, Donna Gurriere, Licensing Program Analyst (LPA) arrived at the facility unannounced to deliver final findings regarding a complaint that was received on 04/21/23. LPA Gurriere met with Stacey Baxter, Administrator Assistant and explained the purpose of the visit.

The facility is operating without an Administrator.

On 04/28/23, Diania Bingham submitted a copy of her administrator certificate to the licensing agency. On 05/01/23 a complaint was received that the facility was operating without an administrator. Ms. Bingham reported to the licensing agency that she would like to be listed as the administrator and the licensing agency accepted her request, effective 04/28/23. Documents were received to include the administrator certificate which was effective 04/28/23 to 04/27/25.

Based on information above, the department concluded that the allegation is Unfounded. A finding that an allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Lauren Crocker	TELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Donna Gurriere	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

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 3

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
05/01/2023 and conducted by Evaluator Donna Gurriere

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20230501082310

FACILITY NAME:	ROSELEAF GARDENS		FACILITY NUMBER:	045002775
ADMINISTRATOR:	SMITH, AUDRE		FACILITY TYPE:	740
ADDRESS:	2770 SIERRA LADERA		TELEPHONE:	(530) 895-0800
CITY:	CHICO	STATE: CA	ZIP CODE:	95928
CAPACITY:	56	CENSUS: 38	DATE:	10/10/2023
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	STACEY BAXTER		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff without appropriate training are providing care for residents.

INVESTIGATION FINDINGS:

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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lauren Crocker	TELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Donna Gurriere	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 59-AS-20230501082310

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: ROSELEAF GARDENS	FACILITY NUMBER: 045002775
	VISIT DATE: 10/10/2023

NARRATIVE

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continued

During the investigative process, two cooks were interviewed to ask if they had provided any type of care and supervision to the residents as alleged. Both cooks stated that they do not and have not provided care. Also, it was alleged that the assistant administrator was providing care to the residents without training. When the assistant administrator was interviewed, she advised that she has provided care and supervision to the residents and that her training included care and supervision courses, plus 10 years as a medication technician. All other staff persons stated that the allegation is not true.

Due to the information above, CCL finds the allegation to be Unsubstantiated meaning 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.

SUPERVISOR'S NAME: Lauren Crocker	TELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Donna Gurriere	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

LIC9099 (FAS) - (06/04)

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