312700042-2-12-2025-59-AS-TORZ-DE8RYB-20250225122604

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 312700042
Report Date: 02/12/2025
Date Signed: 02/12/2025 02:04:25 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
09/04/2024 and conducted by Evaluator Kevin Mknelly

COMPLAINT CONTROL NUMBER: 59-AS-20240904164258

FACILITY NAME:	SUMMERSET LINCOLN ASSISTED LIVING AND MEMORY CARE		FACILITY NUMBER:	312700042
ADMINISTRATOR:	MEGAN GALLAGHER		FACILITY TYPE:	740
ADDRESS:	567 3RD STREET		TELEPHONE:	(916) 409-4150
CITY:	LINCOLN	STATE: CA	ZIP CODE:	95648
CAPACITY:	132	CENSUS: 58	DATE:	02/12/2025
		UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Megan Gallagher		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff did not provide medical attention to resident in a timely manner.
Facility has insufficient staff to provide care to residents.
Staff not meeting resident’s dietary needs.

INVESTIGATION FINDINGS:

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On February 12, 2025, Licensing Program Analyst (LPA) Kevin Mknelly conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with Administrator.

The department conducted records review and extensive interviews.
LPA is unable to find and or meet the preponderance, per policy for the following allegations:
Staff did not provide medical attention to resident in a timely manner- The two incident for R1 that were mentioned on the complaint found that there was not sufficent evidence that the allegation could be substantiated. The incidents in July and August of 2024 where R1 experienced changes in their condition were documented and staff interviewed to show that staff responded as directed by R1's physician and according to R1's plan of care. Following each incident of a previously unidentified care need, R1's physician was contacted and the plan of care was updated as needed.
Facility has insufficient staff to provide care to residents- Staff schedules for August and September 2024 were reviewed as well as staff and residnt interviews conducted. Additional evidence was not found to support that there were insuffient staff to meet the needs of resident identified care needs.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025

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 59-AS-20240904164258

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: SUMMERSET LINCOLN ASSISTED LIVING AND MEMORY CARE	FACILITY NUMBER: 312700042
	VISIT DATE: 02/12/2025

NARRATIVE

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Staff not meeting resident’s dietary needs- the facility is licensed as a non-medical/ non- secure facility. Records and observations of R1 found R1 to be able to freely ambulate in the facility. Furthermore, R1, due to memory impairment was unable to retain physician's recommendation to limit fluids and types of drinks. If R1 was observed to exceed fluids guidance, the facility staff notified the physician of R1's observed intake. When R1 was observed to be seeking excessive fluids, staff intervened to offer information to R1 and attempt to redirect. If R1 continued to insist, staff did not violate R1's personal rights.

As a result of this investigation, LPA finds allegation to be (US)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 with administrator.

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

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
09/04/2024 and conducted by Evaluator Kevin Mknelly

COMPLAINT CONTROL NUMBER: 59-AS-20240904164258

FACILITY NAME:	SUMMERSET LINCOLN ASSISTED LIVING AND MEMORY CARE		FACILITY NUMBER:	312700042
ADMINISTRATOR:	MEGAN GALLAGHER		FACILITY TYPE:	740
ADDRESS:	567 3RD STREET		TELEPHONE:	(916) 409-4150
CITY:	LINCOLN	STATE: CA	ZIP CODE:	95648
CAPACITY:	132	CENSUS: 58	DATE:	02/12/2025
		UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Megan Gallagher		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Unlawful evicted.
Staff not properly trained to provide care to residents.

INVESTIGATION FINDINGS:

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On Febraury 12. 2025 , Licensing Program Analyst (LPA) Kevin Mknelly LPA Mknelly arrived and met with Administrator to deliver investigation findings.
The department reviewed staff records, facility records, and conducted interviews.
The department finds that facility met Tittle 22 requirements for the following allegations:
Unlawful evicted- Records and interviews found that a formal eviction notice was not issued to R1. R1 moved voluntarily from the facility in December 2024. Facility staff had had candid discussions with R1's representative regarding whether this facility was the best fit for R1 and representative to meet the non-licensed requests for service. The dicsussions did not state that an eviction would be issued.
Staff not properly trained to provide care to residents- Staff training records reviewed for the staff in incidents reported in this complaint. Records and interviews found that the facility staff had documented training as required under regulations.
This agency has investigated the above complaint allegations. We have found that the complaint is UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

Exit interview conducted and report provided.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 3