317005628-8-8-2023-59-AS-MSEY-CUPP97-20230814110640

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 317005628
Report Date: 08/08/2023
Date Signed: 08/08/2023 04:07:05 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
07/31/2023 and conducted by Evaluator Melissa Parks

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20230731125447

FACILITY NAME:	ESKATON LODGE GRANITE BAY		FACILITY NUMBER:	317005628
ADMINISTRATOR:	DELGADO, KIMBERLY (KIM)		FACILITY TYPE:	740
ADDRESS:	8550 BARTON RD		TELEPHONE:	(916) 789-0326
CITY:	GRANITE BAY	STATE: CA	ZIP CODE:	95746
CAPACITY:	118	CENSUS: 96	DATE:	08/08/2023
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Kim Delgado		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff not supervised resulting in medication errors
Staff refusing to give residents medication
Resident hygiene needs not being met
Staff not trained
Fire doors propped open illegally
Staff yelling at residents
Injuries not addressed by staff

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Melissa Parks arrived unannounced on August 8, 2023, to complete and deliver findings for a complaint received on 7/31/2023. LPA met with Administrator Kim and explained the purpose of the visit.

Throughout the course of investigation, LPA interviewed residents, caregivers and med techs. LPA reviewed narcotic logbooks for downstairs and upstairs residents. LPA reviewed training records for new med techs. Through record review, LPA learned that there have not been missed medications. Through review, management has observed staff omitting a signature, but the medications were given. Residents and staff interviewed stated that medications were given timely. Interviews revealed that at no time has the facility not had a med tech on site. All interviewed stated that hygiene needs were being met. If residents refused showers, staff would contact management to become involved. No residents or staff observed staff yelling at residents.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Melissa Parks	TELEPHONE: (559) 580-5423
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

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 59-AS-20230731125447

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ESKATON LODGE GRANITE BAY	FACILITY NUMBER: 317005628
	VISIT DATE: 08/08/2023

NARRATIVE

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Staff interviewed stated that any bruising, cuts, etc. on residents were addressed by med techs. Those interviewed stated that some residents have home health treating their wounds. Staff interviewed stated that they have not observed any untreated injuries on residents.

LPA reviewed trained records and noted that new staff were adequately trained per regulations with topics including medication management, Dementia, resident rights, activities, ADLs, etc. Records show the required training hours. Staff interviewed stated that new staff were properly trained.

LPA learned that during the facility's interior refresh, one fire door in the back hallway was not working properly. Upon LPA's facility visit, LPA observed the fire door to be closed (one half of the door was working, one half of the door was closed). Residents were still able to utilize the hallway without opening the door. LPA was notified by the Administrator on 8/1/2023, that a loose wire was reattached, and the fire door was working properly.

Based on the evidence provided, the preponderance of evidence standards was not met, therefore, the above allegations are found to be UNFOUNDED. An unfounded allegation means that the allegation was false, could not have happened and/or is without a reasonable basis.

Exit interview conducted. A copy of this report was provided.

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Melissa Parks	TELEPHONE: (559) 580-5423
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

LIC9099 (FAS) - (06/04)

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