216803982-12-14-2023-21-AS-VBEI-CYMTAZ-20231218133421

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 216803982
Report Date: 12/14/2023
Date Signed: 12/14/2023 10:59:11 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/04/2023 and conducted by Evaluator Helena Rummonds

COMPLAINT CONTROL NUMBER: 21-AS-20231004131538

FACILITY NAME:	ANTON POINTE, THE		FACILITY NUMBER:	216803982
ADMINISTRATOR:	ODIWE, CLEDA M.		FACILITY TYPE:	740
ADDRESS:	1470 SOUTH NOVATO BLVD.		TELEPHONE:	(415) 897-1055
CITY:	NOVATO	STATE: CA	ZIP CODE:	94947
CAPACITY:	10	CENSUS: 8	DATE:	12/14/2023
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Administrator/Licensee, Cleda Odiwe		TIME COMPLETED:	11:10 AM

ALLEGATION(S):

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Facility is not meeting resident's care needs
Personal Rights
Call buttons not working
Facility is not providing meals per regulation

INVESTIGATION FINDINGS:

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At approximately 09:15AM, Licensing Program Analysts (LPAs) Rummonds and Felias arrived unannounced to deliver findings for a Complaint Investigation regarding the above allegations and met with Administrator/Licensee, Cleda Odiwe.
During the course of the Investigation, LPAs requested and reviewed documents, conducted interviews and made observations. There is an allegation of Facility not meeting resident’s care needs. Reporting Party stated that Resident 1 (R1) is not getting showered or having their nails trimmed. On 10/03/2023, the Reporting Party informed the Department that R1’s nails were taken care of. Review of R1’s Physician’s Report dated 08/04/2023 showed that R1 does not need assistance with bathing, grooming, continence care, or feeding themselves. R1’s Resident Appraisal dated 08/14/2023 showed that R1 does need some assistance with bathing and dressing. Resident interviews conducted stated that they are bathed infrequently. Facility documents showed that residents have been receiving showers regularly. (Continued on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Bethany Moellers	TELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Helena Rummonds	TELEPHONE: (707) 588-5057
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

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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Control Number 21-AS-20231004131538

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: ANTON POINTE, THE	FACILITY NUMBER: 216803982
	VISIT DATE: 12/14/2023

NARRATIVE

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Continued from LIC9099

LPAs conducted a visit on 11/30/2023 and observed that all residents in the facility appeared to be clean. Based on interviews conducted, review of documents, and observations made, this allegation is Unsubstantiated.

There is an allegation of Personal Rights. Reporting Party stated that staff are loud at nighttime and are passive aggressive to R1. Reporting Party stated that staff act like they are upset and show frustration when working with R1, and that staff have yelled at R1. LPAs conducted 3 interviews. 2 of 3 interviews stated that there have been disagreements between staff and residents but it is unclear if there was yelling involved. Interviews conducted did state that some residents in the facility will yell at night and the noise level can be upsetting. One interview conducted with an Outside Party stated that they have not observed any negative interactions between staff and residents during their visits. During visits conducted on 10/12/2023, 11/02/2023, and 11/30/2023, LPAs did not observe staff yelling or speaking to residents in a loud or passive aggressive manner. Based on interviews conducted and observations made, this allegation is Unsubstantiated.

There is an allegation that Call buttons are not working. Reporting Party stated that the call buttons do not work at the facility. Resident interviews conducted stated that their pendants do work but that it can take between 15 to 30 minutes for a response. During visit conducted on 11/30/2023, LPAs observed the facility’s call button system to be operable and observed staff members assisting residents when they pressed their pendants. Based on interviews conducted and observations made, this allegation is Unsubstantiated.

There is an allegation that Facility is not providing meals per regulation. Reporting Party stated that staff are not accommodating of R1’s dietary needs due to food allergies and did not provide food to R1 on 09/20/2023, 09/21/2023, and 09/22/2023. Per Title 22 Regulations – 87555 General Food Service Requirements, modified diets prescribed by a resident’s physician as a medical necessity shall be provided. Title 22 Regulations also state that the total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and meet the recommended dietary allowances. Review of R1’s Physician’s Report dated 08/04/2023, and Resident Appraisal dated 08/14/2023 stated that R1 does not have a special diet. Review of R1’s Admissions Agreement dated 08/13/2023 states that special diets are provided if prescribed by a doctor.
Continued on LIC9099-C

SUPERVISOR'S NAME: Bethany Moellers	TELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Helena Rummonds	TELEPHONE: (707) 588-5057
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

LIC9099 (FAS) - (06/04)

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Control Number 21-AS-20231004131538

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: ANTON POINTE, THE	FACILITY NUMBER: 216803982
	VISIT DATE: 12/14/2023

NARRATIVE

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Continued from LIC9099-C

Review of facility documents also stated that R1 was provided 3 meals on 09/20/2023, 09/21/2023, and 09/23/2023. LPAs conducted resident interviews and confirmed that for residents with dietary needs, the facility is accommodating of their dietary restrictions. LPAs were provided with photographs of meals being provided to residents. Observations of the meals provided meet Title 22 Regulations. Based on interviews conducted, review of documents, and observations made, this allegation is Unsubstantiated.

A finding that a complaint allegation is Unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents.

SUPERVISOR'S NAME: Bethany Moellers	TELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Helena Rummonds	TELEPHONE: (707) 588-5057
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

LIC9099 (FAS) - (06/04)

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