317005671-10-20-2023-59-AS-KHOS-CWWGJ3-20231024052229

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 317005671
Report Date: 10/10/2023
Date Signed: 10/20/2023 09:35:50 AM

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
08/30/2023 and conducted by Evaluator Todd Tryon

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20230830082900

FACILITY NAME:	ALMOND GARDENS		FACILITY NUMBER:	317005671
ADMINISTRATOR:	NISHA PATEL		FACILITY TYPE:	740
ADDRESS:	174 ALMOND STREET		TELEPHONE:	(530) 885-5678
CITY:	AUBURN	STATE: CA	ZIP CODE:	95603
CAPACITY:	10	CENSUS: 7	DATE:	10/10/2023
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Marcie Vargas, Care Provider		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff do not protect food against contamination.
Staff did not ensure that residents' incontinence needs are met.
Staff do not make planned activities available to residents

INVESTIGATION FINDINGS:

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Regarding the allegation that staff do not protect food against contamination, LPA toured the kitchen and pantry, spoke with staff and residents. LPA found food in the refrigerators and pantry to be labeed with dates opened. Dates were done in "Sharpie" pen. LPA found no evidence that dates had been changed or altered; and it would be very difficult to try to "erase" dates marked in Sharpie marker without leaving any trace or shadow of old dates; LPA did not find any of this. Staff explained food is marked after it is opened; that fresh foods are only kept for about 3 days then disposed. New food supplies are purchased once a week from a weekly menu, and food is purchased specifically for that menu. Residents interviewed confirmed that food is fresh, they have never been served food that seemed spoiled or old. Food stored appeared in good condition and fresh. LPA finds the allegation to be UNFOUNDED.
Regarding the allegation that staff did not ensure that residents' incontinence needs are met, LPA interviewed staff and residents. LPA was informed that people who need assistance with changes/incontinence are checked at least every 2 hours, more often if necessary. Staff are familiar with each person's needs and habits. There are only a few people in the home who need regular assistance. Hospice

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: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

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-20230830082900

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: ALMOND GARDENS	FACILITY NUMBER: 317005671
	VISIT DATE: 10/10/2023

NARRATIVE

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residents are watched especially closely and staff make sure to change and re-position them regularly. LPA confirmed this while speaking with residents There are currently no hospice residents in this house. The facility appeared to be very clean, and LPA noted no odors during my visit. LPA learned that there apparently was one NOC staff who appeared to not check/change residents as often as needed, but this was quickly brought to the attention of the Administrator who dealt with the issue quickly; and has not been an issue for some time now.
LPA finds the allegation to be UNFOUNDED.
Regarding the allegation that Staff do not make planned activities available to residents, LPA interviewed staff, residents and reviewed the Activity Schedule posted.
LPA learned that there are different activities throughout the month, including an exercise class offered several times a week, weekly Bible Study with a local minister who visits, monthly music programs with a violin player. The home also plays BINGO, does puzzles, play cards. Not all residents choose to participate, but there are various activities that take place. Therefore, the allegation is UNFOUNDED.

The 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.

This document is an amended copy of the original. When originally closing out the complaint at the facility on 9/6/2023 LPA inadvertently did the documents in the wrong order, connecting the 9099C to the 9099, RATHER than the 9099A, to which it should have been linked. This amendment is to correct that paperwork technical error. The findings of the complaint are not changing at all; simply the order in which documents are ordered and connected.

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd Tryon	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

LIC9099 (FAS) - (06/04)

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