342700393-9-30-2021-27-AS-LMUZ-C7DU4K-20211001151516

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700393
Report Date: 09/30/2021
Date Signed: 09/30/2021 04:42:14 PM

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
08/24/2020 and conducted by Evaluator Kevin Mknelly

COMPLAINT CONTROL NUMBER: 27-AS-20200824164715

FACILITY NAME:	COMFORT & CARE		FACILITY NUMBER:	342700393
ADMINISTRATOR:	GROZAV, OKSANA		FACILITY TYPE:	740
ADDRESS:	6916 DRYWOOD WAY		TELEPHONE:	(916) 220-8873
CITY:	ORANGEVALE	STATE: CA	ZIP CODE:	95662
CAPACITY:	6	CENSUS: 3	DATE:	09/30/2021
		UNANNOUNCED	TIME BEGAN:	02:25 PM
MET WITH:	Osaka Grozav		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Resident sustained unexplained bruising while in care
Staff did not administer correct medicine to resident
Staff did not seek medical attention for resident
Staff not practicing proper hygeine methods
Staff not providing adequate food service
Staff yells at residents
Staff not meeting residents needs

INVESTIGATION FINDINGS:

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On 9/30/21, Licensing Program Analyst (LPA) Mknelly arrived unannounced to conduct a complaint investigation visit for a complaint the department received on 8/24/20. LPA met with Oksana Grozav, Licensee/ Administrator, and explained purpose of inspection. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols, contacted the facility to confirm there are currently no positive Covid-19 diagnoses, completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms and completed a facility risk assessment. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical Mask. LPA was again screened per recommendations at the facility.
During today's inspection, LPA discussed several allegations with the Administrator.

LPAs conducted interviews and resident and facility records review
Additionally, LPAs made several attempts to contact the reporting party yet received no return calls.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin Mknelly	TELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2021

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 27-AS-20200824164715

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: COMFORT & CARE	FACILITY NUMBER: 342700393
	VISIT DATE: 09/30/2021

NARRATIVE

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Based on the information available from the facility, the reporting party never worked at the facility therefore had no knowledge about the care of the residents. The reporting party had requested an interview and received an overview of resident care issues yet was not hired.

Records, interviews and inspections found no evidence to support the allegations.

The reporting party did not respond to LPAs' efforts at phone contact.

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

Exit interview conducted and report provided.

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin Mknelly	TELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2021

LIC9099 (FAS) - (06/04)

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