317005900-7-9-2020-27-AS-LMUZ-BRGRBM-20200713125255

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 317005900
Report Date: 07/09/2020
Date Signed: 07/09/2020 01:44:12 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/27/2020 and conducted by Evaluator Pheej Cheng

COMPLAINT CONTROL NUMBER: 27-AS-20200427110052

FACILITY NAME:	MEADOW OAKS OF ROSEVILLE		FACILITY NUMBER:	317005900
ADMINISTRATOR:	JASMINE RIDENOUR		FACILITY TYPE:	740
ADDRESS:	930 OAK RIDGE RD		TELEPHONE:	(916) 774-0200
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95661
CAPACITY:	108	CENSUS: 63	DATE:	07/09/2020
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Jasmine Ridenour; Administrator		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility raised fee without giving proper notice to responsible party.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 7/9/2020 at 1 PM, Licensing Program Analyst (LPA) Cheng conducted an unannounced case management telephone call regarding the allegation above and spoke to Administrator Jasmine Ridenour. A telephone call was made in compliance to the department’s procedures regarding COVID-19.

Based on interview statements and documents received, the department determined that R1 had an increase in care which resulted in an increase of service rates.

Continuation on LIC 9099C.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916)709-6317
LICENSING EVALUATOR NAME: Pheej Cheng	TELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2020

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 2

Control Number 27-AS-20200427110052

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: MEADOW OAKS OF ROSEVILLE	FACILITY NUMBER: 317005900
	VISIT DATE: 07/09/2020

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

The facility provided R1’s three assessment that were conducted between March and April of 2020. R1’s admissions agreement indicates that a change in level in care would result in an immediate increase in fees if the change exceeds the current level of care. Facility documents shows that when R1 was initially admitted into the facility, R1 was at a Level 5 care but increased to a Level 6 after observing that R1 needed a higher level of care. R1’s responsible party was notified via e-mail and was given a 30 day delay in increasing the rates before it went into effect. Although R1's responsible party was notified and given a 30 day delay period before increasing the rates, the facility is not required to provide notice when the results of the increase in rates is due to an increase in level of care. Facility fully assessed R1, generated a new care plan, and informed R1’s responsible party before the increase in fees went into effect.

This agency has investigated the complaint allegations listed above. We have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without reasonable basis. We have therefore dismissed the complaint.

Exit interview conducted and a copy of report along was sent via e-mail.

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916)709-6317
LICENSING EVALUATOR NAME: Pheej Cheng	TELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2020

LIC9099 (FAS) - (06/04)

Page: 2 of 2