342700044-11-21-2023-59-AS-APEZ-CY4PF5-20231201101606

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700044
Report Date: 11/21/2023
Date Signed: 11/21/2023 01:57:22 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
03/28/2023 and conducted by Evaluator Cassie Yang

COMPLAINT CONTROL NUMBER: 59-AS-20230328163916

FACILITY NAME:	OLTEAN'S HOME CARE		FACILITY NUMBER:	342700044
ADMINISTRATOR:	OLTEAN, DIANNE		FACILITY TYPE:	740
ADDRESS:	4213 WALNUT AVE		TELEPHONE:	(916) 484-1763
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	6	CENSUS: 6	DATE:	11/21/2023
		UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Mariana Oltean		TIME COMPLETED:	02:10 PM

ALLEGATION(S):

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Residents are chemically restrained with medication
Facility staff not fingerprint-cleared

INVESTIGATION FINDINGS:

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Licenisng Program Analysts (LPAs) Cassie Yang and Cheyenne Ratajczak arrived unannounced at the facility to deliver the findings for the allegations cited above. LPAs met with Administrator, Mariana Oltean, and explained the purpose of the visit.

During this investigation, the Department conducted extensive interviews and file reviews.

The results of the investigation are as follows.

Please continue on LIC 9099-C...

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Cassie Yang	TELEPHONE: 916-201-1928
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

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-20230328163916

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: OLTEAN'S HOME CARE	FACILITY NUMBER: 342700044
	VISIT DATE: 11/21/2023

NARRATIVE

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Allegation: Residents are chemically restrained with medication.
Based file review and medication review, it revealed that residents are only administered medications that are physician ordered. File review of six out of six residents records revealed there are two out of six residents that are prescribed Melatonin for insomnia. LPA observed physician orders present for R1 and R2's melatonin. Based on medication review, LPA did not observed the presence of Benadryl or any non prescribed sleeping medication presence at the facility. Based on information obtained, LPA finds the allegation to be UNFOUNDED-means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Allegation: Facility staff not fingerprint- cleared.
Based on file review, it revealed there are seven (7) caregivers listed on the LIC 500. File review revealed 7 out of 7 caregivers listed on LIC 500 are fingerpinted-cleared and additionally, 7 out of 7 staff are associated to the facility roster via Guardian. Based on information obtained, LPA finds the allegation to be UNFOUNDED-means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview conducted. Copy of report and appeal rights was provided to Administrator.

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Cassie Yang	TELEPHONE: 916-201-1928
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 3

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
03/28/2023 and conducted by Evaluator Cassie Yang

COMPLAINT CONTROL NUMBER: 59-AS-20230328163916

FACILITY NAME:	OLTEAN'S HOME CARE		FACILITY NUMBER:	342700044
ADMINISTRATOR:	OLTEAN, DIANNE		FACILITY TYPE:	740
ADDRESS:	4213 WALNUT AVE		TELEPHONE:	(916) 484-1763
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	6	CENSUS: 6	DATE:	11/21/2023
		UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Mariana Oltean		TIME COMPLETED:	02:10 PM

ALLEGATION(S):

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Staff are using drugs while on duty
Facility staff are abusing residents

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Cassie Yang and Cheyenne Ratajczak arrived unannounced at the facility to deliver the findings for the allegation cited above. LPAs met with Administrator, Mariana Oltean, and explained the purpose of the visit.

This investigation, the Department conducted a tour of staff room and checked on (5) residents in the commons and (1) in private bedroom. Observations did not find supporting evidence as LPA observed residents watching television during time of inspection on 4/6/2023 and reported they are "fine".

Result of this investigation, LPA finds allegation:
-Staff are using drugs while on duty
-Facility staff are abusing residents.
to be (US) 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 the evidence to prove that the alleged violation occurred.

Exit interview conducted. Copy of report and appeal rights was provided to Administrator.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Cassie Yang	TELEPHONE: 916-201-1928
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

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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