107209035-5-20-2022-24-AS-MHON-CEQTR6-20220524145702

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107209035
Report Date: 05/20/2022
Date Signed: 05/20/2022 10:02:21 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/23/2022 and conducted by Evaluator Mai Yang

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20220223151826

FACILITY NAME:	TRUEWOOD BY MERRILL, CLOVIS		FACILITY NUMBER:	107209035
ADMINISTRATOR:	FLAHERTY, TRACY		FACILITY TYPE:	740
ADDRESS:	675 W ALLUVIAL AVENUE		TELEPHONE:	(559) 325-8400
CITY:	CLOVIS	STATE: CA	ZIP CODE:	93611
CAPACITY:	148	CENSUS: 113	DATE:	05/20/2022
		UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Administrator Rob Huntley and Health Services Director Laurie Johnson		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Facility failed to seek timely medical attention for a resident resulting in serious injury
Facility did not report change in resident condition to responsible party

INVESTIGATION FINDINGS:

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On 05/20/22, Licensing Program Analyst (LPA) M. Yang arrived unannounced to deliver findings on the above allegations. LPA introduced self, stated the purpose of the visit, and met with Administrator Rob Huntley and Health Services Director Laurie Johnson.

During the course of the investigation, interviews were conducted with staff and medical records were reviewed. It could not be proven or disproven that resident had a change of condition specifically related to skin integrity, that would have prompted staff to seek medical attention for resident or notify of the responsible party (RP) of any changes in resident’s condition, however on the morning of 2/10/22, when staff observed a strong odor in resident’s urine, they sought immediate medical attention and notified the responsible party that morning.

Based on interviews and records review, the allegations that facility failed to seek medical attention for a resident resulting in serious injury and that facility failed to notify the RP of resident’s change of condition are UNSUBSTANTIATED, meaning there is not a preponderance of evidence to prove or disprove the alleged violations occurred. No deficiencies issued. An exit interview was conducted. A copy of this report was provided to the Administrator.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 243-8080
LICENSING EVALUATOR NAME: Mai Yang	TELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2022

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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