097004177-10-1-2024-59-AS-MSEY-D9TLFJ-20241007084309

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 097004177
Report Date: 10/01/2024
Date Signed: 10/01/2024 01:25:17 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
07/25/2024 and conducted by Evaluator Lavinia Muscan

COMPLAINT CONTROL NUMBER: 59-AS-20240725150447

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: 176	DATE:	10/01/2024
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Administrator Landon Pilegaard		TIME COMPLETED:	01:40 PM

ALLEGATION(S):

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Staff did not ensure resident wound care needs were met

INVESTIGATION FINDINGS:

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On 10/1/24, Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced to deliver complaint findings into the allegation listed above and met with Administrator Landon Pilegaard. During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation. The results of the investigation are as follows:Based on interviews, record reviewed and observation it was determined that the facility is meeting residents’ hygiene needs, including first aid and wound care, based on the residents needs and service plan. The facility uses correct bandages according to First Aid training. Department toured the facility on 7/29/24 and 9/25/24 and did not find any concerns. Two (2) resident interviews stated the caregivers/staff clean the facility and take care of their first aid needs, as needed, using correct bandages, no feminine products. Additionally, seven (7) staff and two (2) resident interviews did not indicate any issues at the facility with cleanliness, sanitation, and first aid and wound care. Based on all this information, the allegation is found to be 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: Lavinia Muscan	TELEPHONE: 916-263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024

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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