312700263-5-12-2022-25-AS-TORZ-CF22UD-20220602174211

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 312700263
Report Date: 05/12/2022
Date Signed: 05/12/2022 03:29:02 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
05/10/2022 and conducted by Evaluator Kerry Hiratsuka

COMPLAINT CONTROL NUMBER: 25-AS-20220510143336

FACILITY NAME:	SIERRA POINTE		FACILITY NUMBER:	312700263
ADMINISTRATOR:	GRACE HARTNETT		FACILITY TYPE:	740
ADDRESS:	5161 FOOTHILLS BLVD		TELEPHONE:	(916) 780-3330
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95747
CAPACITY:	140	CENSUS: 116	DATE:	05/12/2022
		UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Grace Hartnett		TIME COMPLETED:	03:40 PM

ALLEGATION(S):

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Facility did not protect resident belongings while the room was being repaired.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kerry Hiratsuka, arrived at the facility unannounced on 05/12/2022, to conduct a Complaint Investigation Visit. LPA conducted COVID-19 Precautionary prescreening, and wore a powered air purifier respirator while at facility. LPA was screened by Front Desk.
LPA interviewed Executive Director (ED) Grace Hartnett and the resident affected by the incident. The facility hired a third party contractor to repair part of the resident's room. The contractor did not properly secure the coverings of the resident belongings which resulted in belongings getting covered in dust but that was not discovered until after the work was done. The facility contacted the contractor and the contractor sent out someone to clean the room. Also the contractor was with the maintenance director the entire time and not left alone in the resident's room.

Because the facility did not cause the the items to get dusty and addressed the issue as soon as it was brought to their attention LPA cannot prove or disprove the issue. Allegation is unsubstantiated.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Kerry Hiratsuka	TELEPHONE: (916) 591-0210
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2022

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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