275202755-4-9-2022-26-AS-KHOS-CDEP5H-20220412110045

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 275202755
Report Date: 04/09/2022
Date Signed: 04/09/2022 02:08:49 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/23/2021 and conducted by Evaluator Victoria Brown

COMPLAINT CONTROL NUMBER: 26-AS-20210623084538

FACILITY NAME:	VISTA HARDEN RANCH		FACILITY NUMBER:	275202755
ADMINISTRATOR:	CARTER, JOY		FACILITY TYPE:	740
ADDRESS:	290 REGENCY CIRCLE		TELEPHONE:	(831) 443-6467
CITY:	SALINAS	STATE: CA	ZIP CODE:	93906
CAPACITY:	0	CENSUS: 63	DATE:	04/09/2022
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Joy Carter		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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5
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8
9

Staff did not provide adequate hygiene care for a resident

INVESTIGATION FINDINGS:

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5
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Licensing Program Analyst (LPA) Victoria Brown arrived unannounced on 4/9/22 at 10:15am on a subsequent visit. This visit is to conclude the complaint investigation of the above mentioned allegation. LPA was met by Joy Carter, Administrator and stated the purpose of the visit. LPA reviewed the interviews conducted by LPA Yatfai Eric Ng on 7/1/21. LPA observed that Resident #5 (R5) resided in the facilitiy for 4 days beginning 5/29/21 until 6/2/21. Administrator Joy Carter stated that before she could address the concerns R5 was relocated. Staff #2 (S2) stated that R5 used a pull-up that was not full and it was requested by responsible party to shower R5 every 3 hours. Regarding allegation, "Staff did not provide adequate hygiene care for a resident" LPA observed there are no staff employed at the facility that worked with R5 during that time period and interviews of residents R1-R4 indicated showers are given and rooms are cleaned. During the visit on 7/1/21, LPA Yatfai Eric Ng observed rooms to be clean. The investigation revealed that based on interviews the allegation is UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is Unsubtantiated. Per the CCR, Title 22, Div.6, Chptr 8, no deficiencies cited. An exit interview held, copy of this report was provided.

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Victoria Brown	TELEPHONE: (209) 814-1955
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2022

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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