315001780-7-26-2024-59-AS-MSEY-D83P2K-20240812105605

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 315001780
Report Date: 07/26/2024
Date Signed: 07/26/2024 04:11:45 PM

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
07/19/2024 and conducted by Evaluator Kevin Mknelly

COMPLAINT CONTROL NUMBER: 59-AS-20240719160546

FACILITY NAME:	GREENING'S CARE HOME		FACILITY NUMBER:	315001780
ADMINISTRATOR:	GREENING, ESTELITA		FACILITY TYPE:	740
ADDRESS:	1030 HAMAN WAY		TELEPHONE:	(916) 740-3358
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95678
CAPACITY:	5	CENSUS: 4	DATE:	07/26/2024
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Estelita Greening		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Facility staff are not ensuring that an appropriately skilled professional is
assisting the resident with injections

INVESTIGATION FINDINGS:

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On 7/26/24, Licensing Program Analyst (LPA) Kevin Mknelly LPA Mknelly arrived and met with Administrator to investigate and deliver investigation findings.
LPA reviewed resident R1 records and interviewed the licensee.
LPA finds that facility met Tittle 22 requirements.
R1 was a resident 5/4/24- 7/5/24. LIC 602 stated R1 independently managed his injections. Discharge inventory found R1 had excess supplies of alcohol pads for his tests and injection. Licensee observed R1 tests and injections. R1 had made proceudres.
Previous allegations that the department investigated on 6/28/24 that were unfounded.
LPA received copies of R1's LIC 602, inventory and emergency contact.
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:

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin Mknelly	TELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2024

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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