312700042-6-6-2022-25-AS-KHOS-CFKN9Q-20220620101619

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 312700042
Report Date: 06/06/2022
Date Signed: 06/06/2022 02:10:50 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, 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
05/26/2022 and conducted by Evaluator Jacob Williams

COMPLAINT CONTROL NUMBER: 25-AS-20220526123404

FACILITY NAME:	SUMMERSET LINCOLN ASSISTED LIVING AND MEMORY CARE		FACILITY NUMBER:	312700042
ADMINISTRATOR:	JO ANN FRANKLIN		FACILITY TYPE:	740
ADDRESS:	567 3RD STREET		TELEPHONE:	(916) 409-4150
CITY:	LINCOLN	STATE: CA	ZIP CODE:	95648
CAPACITY:	132	CENSUS: 69	DATE:	06/06/2022
		UNANNOUNCED	TIME BEGAN:	01:39 PM
MET WITH:	Mark Morris, Executive Director		TIME COMPLETED:	02:20 PM

ALLEGATION(S):

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Staff are locking residents' doors from the outside

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jacob Williams arrived at the facility and met with Mark Morris, Executive Director, to open a complaint investigation into the allegation listed above. LPA wore an N-95 mask and was screened by facility upon entry. Facility staff wore masks while on the premises.

During today’s visit, LPA conducted an interview with Executive Director. Based on information obtained, LPA finds the above allegation to be UNSUBSTANTIATED. A finding that the complaint is unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. There are no deficiencies being cited per Title 22 Regulations, Division 6, Chapter 8. Exit interview conducted. Exit interview conducted and a copy of this report is being provided to the Executive Director.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Jacob Williams	TELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2022

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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