045002778-1-30-2024-59-AS-KHOS-D27JTG-20240206061954

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 045002778
Report Date: 01/30/2024
Date Signed: 01/30/2024 11:51:09 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
01/29/2024 and conducted by Evaluator Donna Gurriere

COMPLAINT CONTROL NUMBER: 59-AS-20240129122625

FACILITY NAME:	ROSELEAF SENIOR CARE		FACILITY NUMBER:	045002778
ADMINISTRATOR:	BINGHAM, DIANIA		FACILITY TYPE:	740
ADDRESS:	2180 HUMBOLDT ROAD		TELEPHONE:	(530) 924-4804
CITY:	CHICO	STATE: CA	ZIP CODE:	95928
CAPACITY:	16	CENSUS: 35	DATE:	01/30/2024
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	DAN DANIELS		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not provide medication as prescribed.
Staff altered a resident's medication without consent.
Staff did not provide adequate supervision resulting in excessive falls.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 01/30/24 Donna Gurriere, Licensing Program Analyst (LPA) arrived at the facility unannounced to deliver final findings regarding a complaint that was received on 12/27/23. LPA Gurriere met with Don Daniels, Resident Care Coordinator and explained the purpose of the visit.

It was determined that the complaint allegations were listed under the wrong Roseleaf facility; therefore, the allegations are unfounded. A new complaint with the allegations are transfered this date to the correct facility, which is Roseleaf Gardens, #045002775.

Due to the information above, the Department finds the allegations to be Unfounded. A finding that the allegations are unfounded means that the allegations are 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: 01/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2024

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 1