317005468-7-11-2022-25-AS-KHOS-CHSLY6-20220830090948

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 317005468
Report Date: 07/11/2022
Date Signed: 07/11/2022 12:34:45 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/07/2022 and conducted by Evaluator Todd Tryon

PUBLIC

COMPLAINT CONTROL NUMBER: 25-AS-20220707131906

FACILITY NAME:	BROOKDALE AUBURN		FACILITY NUMBER:	317005468
ADMINISTRATOR:	MORGAN WHINERY		FACILITY TYPE:	740
ADDRESS:	11550 EDUCATION ST		TELEPHONE:	(530) 888-8847
CITY:	AUBURN	STATE: CA	ZIP CODE:	95602
CAPACITY:	110	CENSUS: 69	DATE:	07/11/2022
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Morgan Whineryt		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Facility has not issue a refund.

INVESTIGATION FINDINGS:

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LPA Tryon arrived at the facility unannounced on 7/11/2022 to open the complaint. Prior to the visit LPA had self-Screened for COVID symptoms, took my temperature, etc. LPA screened again at the entrance to the facility, used hand sanitizer, wore a mask.
LPA met with ED Morgan Whinery. LPA informed her of the complaint and allegations.
Ms. Whinery assured LPA that the facility IS working on giving the resident involved a FULL REFUND plus moving expenses; the company is in the process of gathering information to process the refund. The resident was only moved out a week ago and there has not been adequate time for the refund to be fully processed,.
Although it is true that the refund has not been issued yet, it is in the process. Since the facility is already in the process of refunding all the resident's payments PLUS moving expenses, the allegation that the facility has not issued a refund 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.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd Tryon	TELEPHONE: (916) 208-7709
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/07/2022 and conducted by Evaluator Todd Tryon

PUBLIC

COMPLAINT CONTROL NUMBER: 25-AS-20220707131906

FACILITY NAME:	BROOKDALE AUBURN		FACILITY NUMBER:	317005468
ADMINISTRATOR:	MORGAN WHINERY		FACILITY TYPE:	740
ADDRESS:	11550 EDUCATION ST		TELEPHONE:	(530) 888-8847
CITY:	AUBURN	STATE: CA	ZIP CODE:	95602
CAPACITY:	110	CENSUS: 69	DATE:	07/11/2022
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Morgan Whinery		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Facility accepted a client without a proper assessment

INVESTIGATION FINDINGS:

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Regarding the allegation that the resident was accepted without a proper assessment,through interview of staff and review of facility documentation, LPA learned the following: Ms. Whinery stated that the resident was assessed by a company regional nurse, who did NOT make a proper assessment of the resident's needs. Upon admission, a new assessment was done with the resident, and it was found that the resident had a prohibited health condition and two restricted health care conditions with ongoing need for assistance that the facility is not able to meet due to the resident's level of functioning. The facility DID tell the POA that they would attempt to work with the resident, would apply for an exception for the prohibited condition and try to work out the details, but the POA made the decision to move the resident to a different facility. Therefore, the allegation that the facility accepted a client without a proper assessment is SUBSTANTIATED. A finding that an allegation is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.
The following deficiency is cited as per Title 22 Regulations and the Health and Safety Code.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd Tryon	TELEPHONE: (916) 208-7709
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 25-AS-20220707131906

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: BROOKDALE AUBURN	FACILITY NUMBER: 317005468
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/11/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/11/2022 Section Cited CCR 87456(a)(2)	1 2 3 4 5 6 7	87456 (a)Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8: (2) Perform a pre-admission appraisal. This requirement was not met as evidenced by: Initial assessment did not note prohibited health condition and 2	1 2 3 4 5 6 7	The facility will ensure that each resident is given a complete and thorough assessment to learn and address all resident needs and conditions; and that the facility will be able to assist the resident if accepted. The facility will devise a plan for how
	8 9 10 11 12 13 14	restricted health conditions that required extra care that the resident could not perform for self.	8 9 10 11 12 13 14	ongoing assessments will be performed in the future. Plan to be submitted to CCL by 8/11/2022.
	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: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd Tryon	TELEPHONE: (916) 208-7709
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2022

LIC9099 (FAS) - (06/04)

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