315002806-5-11-2023-25-AS-LMUZ-CSLTKM-20230608144809

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 315002806
Report Date: 05/11/2023
Date Signed: 05/11/2023 04:18:37 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/22/2022 and conducted by Evaluator Kevin Mknelly

COMPLAINT CONTROL NUMBER: 25-AS-20221122143228

FACILITY NAME:	SPRINGVIEW ELDERLY CAREHOME		FACILITY NUMBER:	315002806
ADMINISTRATOR:	ARCEGA, LOVELIE		FACILITY TYPE:	740
ADDRESS:	5536 GRAHAM CT.		TELEPHONE:	(916) 672-6945
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95677
CAPACITY:	6	CENSUS:	DATE:	05/11/2023
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:			TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Licensee is in financial distress.

INVESTIGATION FINDINGS:

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On 5/11/23, Licensing Program Analyst (LPA) Kevin Mknelly met with Myles Parkinson, Licensee of facility Springview Elderly Carehome at approximately 3 PM. The meeting was conducted via Microsoft Teams. Others in attendance were Regional Manager, Alycia Berryman, Licensing Program Manager, Laura Munoz and the department’s programs auditor.

All are present in order to deliver the complaint findings and to develop a working plan with the licensee for resolutions to their current financial circumstances.

The department conducted a financial audit of the licensee beginning in November 2022.
LPA finds that the allegations cited above are substantiated.

Report continued

Substantiated

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: 05/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023

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 25-AS-20221122143228

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

FACILITY NAME: SPRINGVIEW ELDERLY CAREHOME	FACILITY NUMBER: 315002806
	VISIT DATE: 05/11/2023

NARRATIVE

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The Department’s audit found that there were insufficient funds, not paying rent, behind on utility bills, money spent on food is not adequate. Therefore, the Department determined that the licensee is out of compliance with regulation 87213 Finances.

As a result of this investigation, LPA finds allegation to be (S) Substantiated - A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. The following deficiencies were cited on 9099-D, per Title 22 Regulations, Division 6. (A)This poses an immediate Health and Safety risk to clients/residents in care. (B) This poses a potential Health and Safety risk, or personal rights violation, to clients/residents in care.

Report reviewed with Administrator. Copy of this report and appeal rights provided.

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin Mknelly	TELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023

LIC9099 (FAS) - (06/04)

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Control Number 25-AS-20221122143228

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

FACILITY NAME: SPRINGVIEW ELDERLY CAREHOME	FACILITY NUMBER: 315002806
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/11/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 05/15/2023 Section Cited CCR 87213	1 2 3 4 5 6 7	Finances . The licensee shall have a financial plan that conforms to the requirements of Section 87155, Application for License, and that assures sufficient resources to meet operating costs for care of residents... This requirement was not met as evidenced by	1 2 3 4 5 6 7	Licensee will submit a written plan for maintenance or closure of the facility as well as a plan for keeping payment of operations costs current throughout this process. The POC is due by 5/15/23
	8 9 10 11 12 13 14	by the department's audit which found an inadequate finacial plan to support operations needed for the needs of residents. This posed an immediate risk to residents.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin Mknelly	TELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023

LIC9099 (FAS) - (06/04)

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