342700487-2-3-2025-59-AS-LMUZ-DDSTAG-20250211133331

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700487
Report Date: 02/03/2025
Date Signed: 02/03/2025 01:28:33 PM

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
10/10/2024 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 59-AS-20241010142410

FACILITY NAME:	A HEARTY CARE HOME II		FACILITY NUMBER:	342700487
ADMINISTRATOR:	CLARDY, MARIA		FACILITY TYPE:	740
ADDRESS:	5712 HERBAL WAY		TELEPHONE:	(916) 664-3180
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95835
CAPACITY:	6	CENSUS: 5	DATE:	02/03/2025
		UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Staff, Janna Flores		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Resident sustained multiple unexplained injuries.
Facility staff hit resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced on 02/03/25 to deliver complaint findings for above allegations. LPA met with Staff, Janna Flores, and informed her the reason for the visit. LPA and staff spoke with administrator,Angelita Dayoan via phone and administrator gave permission to staff to assist LPA with today's visit and sign the report since administrator was not able to come.

The department conducted records review ,facility observations and interviews to investigate the complaint.

**Report continued on LIC9099-C**

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Talwinder Bains	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2025

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-20241010142410

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: A HEARTY CARE HOME II	FACILITY NUMBER: 342700487
	VISIT DATE: 02/03/2025

NARRATIVE

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***Report continued from 9099....

Allegation- Resident sustained multiple unexplained injuries. Facility staff hit resident.

The Department conducted record review, interviews with staff and residents to investigate the allegation. During investigation, it was learnt that resident, R1 was a long-term resident at the facility. R1 had a diagnosis of dementia and based on interviews, R1 was resistant to care and had a tendency to be combative towards staff. On October 1, 2024, newly hired staff, S1 and S2 were at the facility working by themselves. When S1 and S2 attempted to assist R1 with incontinence care, R1 became combative towards S1 and S2.

Interviews indicated that R1 was sent to the hospital on October 2, 2024 where it was noticed by hospital personnel that R1 had some scratches and bruises on their body. There was no explanation as to where R1’s bruising came from and R1 was discharged back to the facility on the same day without any changes.

Licensee stated that S1 and S2 were not a good fit for the facility due to their lack of patience with R1’s behaviors and were terminated on October 2, 2024.

Based on interviews conducted, there is insufficient evidence that the bruising and scratching R1 sustained was a result of neglect by facility staff. Additionally, there was no substantial evidence that shows facility staff hit resident therefore this allegations were found to be Unsubstantiated.

A finding that the complaint allegations is UNSUBSTANTIATED means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

Exit meeting conducted. A copy of this report has been provided to facility.

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Talwinder Bains	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2025

LIC9099 (FAS) - (06/04)

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