342700186-9-20-2022-25-AS-KHOS-CK3NDZ-20221010102311

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700186
Report Date: 09/20/2022
Date Signed: 09/20/2022 03:23:44 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/13/2022 and conducted by Evaluator Jacob Williams

COMPLAINT CONTROL NUMBER: 25-AS-20220913162033

FACILITY NAME:	WALNUT HOUSE		FACILITY NUMBER:	342700186
ADMINISTRATOR:	LACY BERRY		FACILITY TYPE:	740
ADDRESS:	3401 WALNUT AVE		TELEPHONE:	(916) 483-6612
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	110	CENSUS: 81	DATE:	09/20/2022
		UNANNOUNCED	TIME BEGAN:	11:56 AM
MET WITH:	Lacy Berry, Administrator		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff did not provide a comfortable temperature for resident in care.

INVESTIGATION FINDINGS:

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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Jacob Williams	TELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022

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 3

Control Number 25-AS-20220913162033

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: WALNUT HOUSE	FACILITY NUMBER: 342700186
	VISIT DATE: 09/20/2022

NARRATIVE

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Allegation: Staff did not provide a comfortable temperature for resident in care.

Six (6) residents were interviewed in R1's hallway on the western far-end of the facility. 4 of 6 residents do not report experiencing any high temperatures in their room. 2 of 6 residents report experiencing uncomfortably high temperatures in their rooms during recent heatwave. It is learned that repairman responded to the complaints of high temperatures in these two rooms and fixed the issue when he was alerted. Caregivers have also worked with the two residents during the heatwave to increase air flow through their rooms by opening window and the door to the hallway in order to create a draft and cool down temperatures. When staff were asked what they would do if a resident complained of uncomfortably hot temperatures, all stated they would either supply them a fan or open window/door to create a draft. Administrator stated if a resident asks to move to a cooler room, as long as there is an available room with the same cost as their current room then administrator is happy to relocate them.

Based on observation and interviews conducted, the preponderance of evidence standards have not been met. Therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that a complaint allegation 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 was conducted with Administrator and a copy of this report was provided to the facility. The signature of the Administrator on these forms acknowledges receipt of these documents.

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Jacob Williams	TELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022

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
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/13/2022 and conducted by Evaluator Jacob Williams

PUBLIC

COMPLAINT CONTROL NUMBER: 25-AS-20220913162033

FACILITY NAME:	WALNUT HOUSE		FACILITY NUMBER:	342700186
ADMINISTRATOR:	LACY BERRY		FACILITY TYPE:	740
ADDRESS:	3401 WALNUT AVE		TELEPHONE:	(916) 483-6612
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	110	CENSUS: 81	DATE:	09/20/2022
		UNANNOUNCED	TIME BEGAN:	11:56 AM
MET WITH:	Lacy Berry, Administrator		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Facility's air conditioner is in disrepair.

INVESTIGATION FINDINGS:

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On 09/20/2022, Licensing Program Analyst (LPA) Jacob Williams arrived at the facility and met with Lacy Berry regarding a complaint investigation into the allegation listed above. LPA wore a surgical mask and was screened by facility upon entry. Facility staff wore masks while on the premises.

During the investigation, the Department toured the facility and conducted interviews with Residents 1-6 and staff 1-5. Maintenance manager states that during a time of day when sun is facing residents exterior wall, temperature may rise due to single-pane windows. 4 of 6 residents interviewed in R1's wing of facility say they never experienced elevated temperatures in their room. 2 of 6 report elevated temperature, are both situated on same exterior wall. It is determined that air conditioning unit never went out of service during the regions recent extreme heat wave that occurred during the weekend of 9/9/22-9/12/2022.

Based on the evidence provided, the preponderance of evidence standards was not met, therefore, the above allegation is 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 to Administrator.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Jacob Williams	TELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 3