310302384-2-3-2022-25-AS-KHOS-CE3KD6-20220503074814

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 310302384
Report Date: 02/03/2022
Date Signed: 02/03/2022 03:47:52 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/03/2022 and conducted by Evaluator Todd Tryon

COMPLAINT CONTROL NUMBER: 25-AS-20220203103242

FACILITY NAME:	EDGEWOOD GUEST HOME		FACILITY NUMBER:	310302384
ADMINISTRATOR:	ANDRADA, T. AND R.		FACILITY TYPE:	740
ADDRESS:	1361 MARTIN DRIVE		TELEPHONE:	(530) 885-9613
CITY:	AUBURN	STATE: CA	ZIP CODE:	95603
CAPACITY:	15	CENSUS: 14	DATE:	02/03/2022
		UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Tito Andrada, Jr.		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff acted rough with clients.

INVESTIGATION FINDINGS:

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LPA Tryon arrived at the facility to open the complaint. LPA had self-screened for COVID prior to the visit, took my own temperature, etc. LPA wore an N-95 mask as per current protocol. LPA was screened again by the staff at the home. LPA met with Tito Andrada Jr. at the facility. The allegation was that staff was rough with clients during a furniture delivery on 1/5/2022. LPA has spoken with staff, and spoken with residents involved in the incident and several other residents. Staff also showed LPA the area where residents were located where the delivery people were walking by. LPA found no evidence that the staff involved was in any way abusive or aggressive towards any residents. LPA did learn that when the delivery people came to the facility they were very much in a rush to deliver the chairs they had brought and leave quickly. The delivery people had reportedly refused to don masks for safety or do any screening or answer questions as per COVID protocols at the time; and the staff was trying to get residents as far back away from the path of the delivery people as possible to avoid any potential COVID exposure. Staff stated he was speaking loudly to the residents to have them get back out of the way; and stood in front of a resident in the resident's bedroom doorway and asked him to go back inside for a minute to keep back from the delivery people.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd Tryon	TELEPHONE: (916) 208-7709
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022

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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Control Number 25-AS-20220203103242

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: EDGEWOOD GUEST HOME	FACILITY NUMBER: 310302384
	VISIT DATE: 02/03/2022

NARRATIVE

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In speaking with the residents, all said that the staff was not mean to them, no one took it as abuse or anger from staff, seemed to understand he was redirecting them for safety. All stated the staff person has never abused them. All who were questioned stated they like the staff and he has never been mean to anyone.

At this time, although it appears staff may have been speaking loudly or "yelling" at residents during the delivery of furniture, it was done in the spirit of keeping everyone safe and healthy; and no one felt they had been abused in any way. The allegation is therefore UNFOUNDED.

A finding of unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview conducted.

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd Tryon	TELEPHONE: (916) 208-7709
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022

LIC9099 (FAS) - (06/04)

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