312700574-10-26-2023-59-AS-KHOS-CYERC9-20231211115358

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 312700574
Report Date: 10/25/2023
Date Signed: 10/26/2023 09:55:12 AM

Unfounded

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
10/19/2023 and conducted by Evaluator Todd Tryon

COMPLAINT CONTROL NUMBER: 59-AS-20231019160403

FACILITY NAME:	ANSEL PARK SENIOR LIVING COMMUNITY		FACILITY NUMBER:	312700574
ADMINISTRATOR:	DEBORAH TAYLOR		FACILITY TYPE:	740
ADDRESS:	1200 ORCHID DRIVE		TELEPHONE:	(916) 250-0770
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95765
CAPACITY:	100	CENSUS: 78	DATE:	10/25/2023
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Deborah Taylor, Executive Director		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff do not provide adequate food service.
Facility staff are not ensuring the facility is maintained.

INVESTIGATION FINDINGS:

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On 10/25/2023 LPA Tryon visited the facility to open this complaint. LPA met with Executive Director Deborah Taylor. LPA spoke with E.D., staff and residents; reviewed kitchen sanitation training records and viewed lunch meal, food supplies, dishes and utensils.
Regarding the allegation that staff do not provide adequate food service, LPA found that food supplies appeared to be plentiful, varied and fresh. LPA viewed open bread packs/sandwiches on plates and saw no sign that the bread was not fresh; it appeared very fresh. LPA learned that bread is purchased and stored frozen, (or made fresh daily), is only taken out of the freezer one day before being used. Bread is taken out in quantities that are estimated to be needed, and most supplies are used each day as opened. Any leftovers are put on the front of the bread carts to be used first the next day. LPA viewed lettuce supplies which were fresh, and viewed plated salads/sandwiches, lettuce appeared fresh and not wilted. LPA learned that lettuce is ordered 3 or 4 times fresh a week; cases are only used for 3 days at the most. LPA viewed ranch and other salad dressings. Ranch was stored in a large rectangular container, was tightly covered with plastic wrap and dated with expiration date. LPA learned that the dressing is made fresh at the facility with buttermilk and ranch powder mix.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd Tryon	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2023

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-20231019160403

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: ANSEL PARK SENIOR LIVING COMMUNITY	FACILITY NUMBER: 312700574
	VISIT DATE: 10/25/2023

NARRATIVE

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The mix contains preservatives that keep the dressing for up to 30 days. This practice was listed on the directions for the dressing; and confirmed with the facility dietician.
Regarding the cook using unwashed hands with no gloves to handle raw meat, LPA learned that under the safe handling food practices the cook does not need gloves to handle/trim meat before cooking. Cook always use gloves to handle all prepared/cooked foods that will be served. Hands are washed before and after handling meat and other food. Hands are washed before donning gloves, between glove changes and after using gloves.
LPA spoke with 12 residents during lunch; all stated the food was good and had no complaints.

LPA found no evidence that there is any substandard food being served or of unsafe food handling. Allegation is UNFOUNDED,

Regarding the allegation that facility staff are not ensuring the facility is maintained, LPA viewed dining room, kitchen, food prep areas, cooler, freezer, food storage. LPA also viewed flatware, dishes, etc. LPA reviewed dishwasher temperature logs. Water temperature was within appropriate temperature range for all meals each day over a span of 5 months. LPA learned that flatware is washed 3 times each time it is used, It is washed once flat on a dishwasher tray/rack; one time with tines face up in silverware "cups" in the dishwasher; and one time tines down. LPA reviewed clean flatware and found no food particles or stains,
LPA viewed the kitchen floor. The floor did not appear spotless, in that there were some marks/scuffs, etc. It should be noted that the floor was viewed during the lunch meal as kitchen staff were busy working all around. LPA learned that the floor is mopped daily; staff are asked to sweep under things to keep any stray items, dirt, etc. cleaned out. LPA learned that the floor is deep cleaned quarterly. Although the floor did not appear spotless or "perfect", it was also not covered with food items, dirt, etc, and appeared within the range of acceptably clean given the heavy traffic and use.
LPA finds the allegation to be 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) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2023

LIC9099 (FAS) - (06/04)

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