317000237-1-19-2023-25-AS-KHOS-CQZNT5-20230418104409

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 317000237
Report Date: 01/19/2023
Date Signed: 01/19/2023 01:40:20 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 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
01/10/2023 and conducted by Evaluator Todd Tryon

PUBLIC

COMPLAINT CONTROL NUMBER: 25-AS-20230110120506

FACILITY NAME:	OAKWOOD VILLAGE, INC.		FACILITY NUMBER:	317000237
ADMINISTRATOR:	JOHN O'BRIEN		FACILITY TYPE:	740
ADDRESS:	3388 BELL ROAD		TELEPHONE:	(530) 889-8122
CITY:	AUBURN	STATE: CA	ZIP CODE:	95603
CAPACITY:	124	CENSUS: 50	DATE:	01/19/2023
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	John O'Brien, Executive Director		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Facility staff not administering residents medication in a timely manner.
Facility staff did not assist residents in a timely manner.
Facility staff not keeping facility free of pests.

INVESTIGATION FINDINGS:

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On 1/19/2022 LPA Tryon visited the facility to open the complaint. LPA met with ED John O'Brien. LPA reviewed documentation and spoke with staff.
Regarding the allegation that facility staff are not administering medication in a timely manner, LPA reviewed MARS and chart notes. LPA found that one of the residents mentioned did miss a medication on 1/26/22 as allegated; but notes state that resident was out with family and that is why medication was missed. Others show medications as taken, so there is no way to prove any differently at this time. Allegation is unfounded.
Regarding facility not assisting resident in a timely manner, the administration was not even aware of the mentioned resident having fallen; and there have been no injuries reported. Also, the time of response was given as 20 minutes as per resident, but there was no other proof of this. As well, response time was not necessarily unreasonable, and staff did in fact respond, to find resident had assisted self and was up and okay. Allegation is unfounded.
Regarding the allegation that facility staff are not keeping the facility free of pests, LPA spoke with ED and learned that the buidling has in fact had rats/mice in the building in the past few weeks, possibly related

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: 01/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023

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-20230110120506

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: OAKWOOD VILLAGE, INC.	FACILITY NUMBER: 317000237
	VISIT DATE: 01/19/2023

NARRATIVE

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[continued] to the excess rains recently, flooding, construction going on in an adjacent property, etc. The facility has an ongoing contract with Clark Pest Control. Clark staff normally come out to the facility one time per month to check and do maintenance of pest control. As soon as the pests were noted recently, the facility contacted Clark right away and increased visits to twice a week, until the issue is resolved. This was verified by paperwork from Clark provided by ED. Therefore, although it is true that there have been rats/pests seen in the building, the staff IS doing something about it and Clark Pest Control continues to work to abate the problem. Therefore, the allegation is Unfounded.

A finding that an allegation is 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: 01/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023

LIC9099 (FAS) - (06/04)

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