317005531-11-18-2022-25-AS-TORZ-CLWPKW-20221208102348

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 317005531
Report Date: 11/18/2022
Date Signed: 11/18/2022 04:19:16 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
08/19/2022 and conducted by Evaluator Todd Tryon

PUBLIC

COMPLAINT CONTROL NUMBER: 25-AS-20220819111439

FACILITY NAME:	SIERRA RIDGE SENIOR LIVING		FACILITY NUMBER:	317005531
ADMINISTRATOR:	NISHA KUAR		FACILITY TYPE:	740
ADDRESS:	3265 BLUE OAKS DR		TELEPHONE:	(530) 887-8600
CITY:	AUBURN	STATE: CA	ZIP CODE:	95602
CAPACITY:	65	CENSUS: 41	DATE:	11/18/2022
		UNANNOUNCED	TIME BEGAN:	03:39 PM
MET WITH:			TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff failed to meet resident’s incontinence needs
Staff leave resident in soiled clothing for extended periods of time.
Staff failed to provide adequate food service.
Facility is unclean
Resident lost severe weight while in care.

INVESTIGATION FINDINGS:

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LPA Tryon visited the facility on 11/18/2022 to complete the complaints. LPA had self-screened for COVID symptoms prior to the visit; and was screened and temperature taken again upon entry. LPA met with Executive Director Ilona Corpus and Associate Executive Director Jennifer Fuston. During this visit LPA interviewed staff and finished up the investigation. Over the course of the investigation LPA has toured the facility, reviewed kitchen, dining area, food supplies, witnessed a meal, reviewed documentation regarding resident, interviewed 6 of 28 staff.
Regarding the allegation that staff failed to meet resident's incontinence needs, LPA learned that residents who needed assistance are placed on 2 to 4 hour checks/changes. LPA learned that Resident R1 was checked on schedule and assisted with toileting and changes as needed. R1 was usually found to be clean, and changed if need There may have been "accidents" on a few occasions, It appears that R1's needs overall were met in the area. Allegation is UNFOUNDED.
Regarding the allegation that Staff leave resident in soiled clothing for extended periods of time. LPA learned that R1 was changed into a clean outfit each morning and clean nightware before bed. There

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: 11/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2022

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-20220819111439

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: SIERRA RIDGE SENIOR LIVING	FACILITY NUMBER: 317005531
	VISIT DATE: 11/18/2022

NARRATIVE

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were times when R1's clothes could become soiled by food or accidents; staff would change R1's clothes as soon as noted. Allegation is UNFOUNDED.
Regarding the allegation that staff failed to provide adequate food service, through tour of kitchen, review of menus, interview of staff, LPA learned that the facility does provide adequate food; and that overall R1 did eat most of the meals most of the time. Staff noted that there didn't appear to be anything in particular that R1 would not eat, and all perceived her to be a good eater. There were a few times several months ago when kitchen staff was short and the other staff filled in to cook, but this was quickly taken care of and kitchen staff has been pretty adequate. There is no evidence that food provided was in any way inadequate. Allegation is UNFOUNDED.
Regarding the allegation that facility is unclean, LPA has toured the facility including multiple resident rooms, interviewed staff regarding cleaning. LPA found the whole facility to be clean, free of odors and in good condition. On prior visits, LPA has never noted the facility to be unclean. LPA learned that resident rooms are cleaned on a regular schedule by housekeeping. Also, care staff pick up regularly as they assist residents in their rooms. If an area is noted to need cleaning, care staff clean up as they can right away, and notify housekeeping of any "deeper" cleaning that is needed. Allegation is UNFOUNDED.
Regarding the allegation that Resident lost severe weight while in care, LPA has reviewed weight charts for R1 over an 8 month period. R1 did gain and lose a few pounds over the 8 months, but there does not appear to have been any large change over the period. Staff interviewed did not find that R1 had any major weight losses, and all perceived that her weight did remain pretty steady throughout her time living at the facility. 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: 11/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2022

LIC9099 (FAS) - (06/04)

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