312700548-2-6-2024-59-AS-MSEY-D2MQZX-20240220113728

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 312700548
Report Date: 02/06/2024
Date Signed: 02/06/2024 11:24:11 AM

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
12/04/2023 and conducted by Evaluator Kevin Mknelly

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20231204140824

FACILITY NAME:	GLENWOOD GARDEN MANOR		FACILITY NUMBER:	312700548
ADMINISTRATOR:	CRUDO, ANGELINA		FACILITY TYPE:	740
ADDRESS:	176 GLENWOOD CIRCLE		TELEPHONE:	(916) 740-2248
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95678
CAPACITY:	6	CENSUS: 5	DATE:	02/06/2024
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Caregiver		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff mismanaged resident's funds
Facility is malodorous
Facility is unsanitary

INVESTIGATION FINDINGS:

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On 2/6/24, Licensing Program Analyst (LPA) Kevin Mknelly conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with Carlos Wong. LPA spoke with licensee by phone.

LPA conducted records review and extensive interviews.
LPA is unable to find and or meet the preponderance, per policy.

Records review and interviews found that licensee does not hold or manage resident funds. R1’s Power of Attorney POA, was interviewed by LPA Mknelly and stated that he sent checks to the care home made out to R1. The checks were cashed. The licensee stated that they assisted R1 to cash checks, R1 would manage all of their own money and R1 would occasionally give cash to the licensee to shop for goods. The licensee returned the purchases and change to R1.
When R1 was interviewed, they denied receiving any money in any of their prior RCFE residences. R1’s POA stated that at times R1 would make such claims, yet the POA also had spoken with R1 about things

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin Mknelly	TELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024

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-20231204140824

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: GLENWOOD GARDEN MANOR	FACILITY NUMBER: 312700548
	VISIT DATE: 02/06/2024

NARRATIVE

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that they purchased with money sent. Evidence was not found to support the allegation that staff mismanaged R1’s funds.

It was alleged that visitors to the home witnessed odors and unclean surfaces related to residents’ incontinence at the facility. Statements from staff and residents were that while there may occasionally be resident incontinence episodes, staff respond quickly to ensure the residents and the home are clean and odor free.
The department conducted inspections on 7/18/23, 12/7/23 and 2/6/24. During the inspections the home was observed to be clean and odor free.
While there could have been an incident where the facility was malodorous and there was need for cleaning of surfaces, there is not additional evidence that occurrences are regularly repeated and staff fail to respond.

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.

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin Mknelly	TELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024

LIC9099 (FAS) - (06/04)

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