052700992-8-4-2023-27-AS-KHOS-CV6LKH-20230829084934

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 052700992
Report Date: 08/04/2023
Date Signed: 08/04/2023 01:14:22 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO AC/SC, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/12/2023 and conducted by Evaluator Kimberly Viarella

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20230612130714

FACILITY NAME:	FOOTHILL VILLAGE SENIOR LIVING		FACILITY NUMBER:	052700992
ADMINISTRATOR:	BITLER, MAUREEN H.		FACILITY TYPE:	740
ADDRESS:	1400 FOOTHILL VILLAGE DRIVE		TELEPHONE:	(805) 801-0404
CITY:	ANGELS CAMP	STATE: CA	ZIP CODE:	95222
CAPACITY:	78	CENSUS: 69	DATE:	08/04/2023
		UNANNOUNCED	TIME BEGAN:	12:36 PM
MET WITH:	Angelica White		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee lacks adequate funds to properly operate facility.

INVESTIGATION FINDINGS:

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

Licensing Program Analyst (LPA) Kimberly Viarella made an unannounced visit to this facility to deliver the findings of a complaint investigation. LPA met with Angelica White, the Resident Care Director, and explained the purpose of the visit.

Regarding the allegation above, based on a review of records, observations, and information gathered during the course of this investigation, this Department found the allegations to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegations may have happened or were valid, there was not a preponderance of the evidence to prove that the alleged violation occurred.
This LPA performed a records review that included a review of paid utility bills, and participated in a Regional Office conference conducted via Microsoft Teams on 07/19/2023 as part of this investigation into the financial stability of Foothill Village. There was not a preponderance of evidence to support the allegation.
Exit interview.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023

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