340313383-3-4-2024-59-AS-MSEY-D34SX6-20240306131523

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 340313383
Report Date: 03/04/2024
Date Signed: 03/04/2024 10:25:30 AM

Unsubstantiated

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
01/10/2024 and conducted by Evaluator Melissa Parks

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20240110121302

FACILITY NAME:	ESKATON VILLAGE		FACILITY NUMBER:	340313383
ADMINISTRATOR:	KLICK, GREG		FACILITY TYPE:	741
ADDRESS:	3939 WALNUT AVE		TELEPHONE:	(916) 974-2000
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	500	CENSUS:	DATE:	03/04/2024
		UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Greg Klick		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Facility fire alarm is in disrepair.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Melissa Parks arrived unannounced on Monday March 4, 2024, to complete and deliver findings for a complaint received on 1/10/2024. LPA met with Administrator Greg and explained the purpose of the visit.

Throughout the course of the investigation, LPA interviewed the Administrator and Campus Patrol. LPA reviewed fire watch logs and emails between the facility and the Fire Department. The result of the investigation is as follows:

LPA learned that between 1/9/2024 and 1/10/2024, there were two false fire alarms that occurred at the facility. The facility learned that one fire detector was defective and immediately replaced the device. A few hours later, the facility learned that the replacement device was defective and replace it. Therefore, there were two false alarms. The facility immediately initiated fire watch (for approximately 20 hours) and supplied the logs to the Fire Department. Separately, the facility has a long-term project, which has been

Unsubstantiated

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: 03/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2024

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-20240110121302

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 VILLAGE	FACILITY NUMBER: 340313383
	VISIT DATE: 03/04/2024

NARRATIVE

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approved by SacMetro, to replace the fire panels, however, this does not impact the system from being fully functional. This project is set to be complete in April 2024.

Based on the evidence provided, the preponderance of evidence standards was not met, therefore, the above allegation is found to be UNSUBSTANTIATED. a finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

Exit interview conducted. A copy of this report was left with the facility.

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Melissa Parks	TELEPHONE: (559) 580-5423
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2024

LIC9099 (FAS) - (06/04)

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