097004177-1-4-2024-59-AS-LMUZ-CZLPY6-20240118104321

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 097004177
Report Date: 01/04/2024
Date Signed: 01/04/2024 09:31:16 AM

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
12/26/2023 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 59-AS-20231226152933

FACILITY NAME:	PONTE PALMERO		FACILITY NUMBER:	097004177
ADMINISTRATOR:	PILEGAARD, LANDON		FACILITY TYPE:	740
ADDRESS:	3083 PONTE MORINO DRIVE		TELEPHONE:	(530) 677-9100
CITY:	CAMERON PARK	STATE: CA	ZIP CODE:	95682
CAPACITY:	250	CENSUS: 196	DATE:	01/04/2024
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Administrator Landon Pilegaard		TIME COMPLETED:	09:45 AM

ALLEGATION(S):

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Facility staff do not ensure residents’ hygiene needs are being met.

INVESTIGATION FINDINGS:

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On 01/04/24, Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced to do complaint investigation and to deliver complaint findings into the allegation listed above and met with Administrator Landon Pilegaard . During the investigation, the Department conducted interviews with 3 staff and 2 residents and reviewed documentation pertinent to the investigation. Staff and residents interviews indicated that residents hygiene needs are met per residents needs and service plan. Staff interiews indicated that memory care staff does not cut residents nails per facility policy and nails care are done for residents by thier families or salon. For hospice residents, it is done by hospice company. Memory care staff clean residents nails as needed. Based upon the information obtained during investigation, the above allegation is unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means 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.
Exit interview was conducted with Administrator and a copy of this report was provided to the facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Talwinder Bains	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2024

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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