342700525-5-26-2021-27-AS-MSEY-C3KPQZ-20210601113157

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700525
Report Date: 05/26/2021
Date Signed: 05/26/2021 12:34:42 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
09/16/2020 and conducted by Evaluator Melissa Lusby

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20200916120617

FACILITY NAME:	ALMOND HEIGHTS		FACILITY NUMBER:	342700525
ADMINISTRATOR:	AGUIAR, TERRI		FACILITY TYPE:	740
ADDRESS:	8685 GREENBACK LN		TELEPHONE:	(916) 542-7988
CITY:	ORANGEVALE	STATE: CA	ZIP CODE:	95662
CAPACITY:	145	CENSUS: 96	DATE:	05/26/2021
		UNANNOUNCED	TIME BEGAN:	11:49 AM
MET WITH:	Terri Aguiar		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Resident sustained injuries due to lack of supervision
Facility not communicating with responsible party
Resident given wrong medication
Staff not responding to calls for assistance
Facility not seeking medical attention.

INVESTIGATION FINDINGS:

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Licensing Program Analyst Melissa Lusby arrived at the facility on Wednesday May 26, 2021 to deliver findings for the complaint investigation. Due to COVID-19 and pre-cautionary measures, LPA wore a N95 mask throughout the visit. LPA met with Administrator Terri Aguiar and discussed the allegations. Throughout the course of the investigation, the Department reviewed facility notes, hospital discharge paperwork, resident file, and conducted relevant party interviews, obtained relevant documentation and evidence.

The Department notes that while R1 did sustain injuries due to falls, the facility conducted reappraisals and implemeneted safety checks as needed. Through staff interviews and documentation, the Department was able to verify that the facility was in constant communication with responsible party. There were no documented medical events where the facility failed to seek medical attention.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Melissa Lusby	TELEPHONE: (559) 580-5423
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2021

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 4

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
09/16/2020 and conducted by Evaluator Melissa Lusby

COMPLAINT CONTROL NUMBER: 27-AS-20200916120617

FACILITY NAME:	ALMOND HEIGHTS		FACILITY NUMBER:	342700525
ADMINISTRATOR:	AGUIAR, TERRI		FACILITY TYPE:	740
ADDRESS:	8685 GREENBACK LN		TELEPHONE:	(916) 542-7988
CITY:	ORANGEVALE	STATE: CA	ZIP CODE:	95662
CAPACITY:	145	CENSUS: 96	DATE:	05/26/2021
		UNANNOUNCED	TIME BEGAN:	11:49 AM
MET WITH:	Terri Aguiar		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Food being served is not good quaility
Staff not trained
Resident belongings went missing without explainantion.

INVESTIGATION FINDINGS:

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Licensing Program Analyst Melissa Lusby arrived at the facility on Wednesday May 26, 2021 to deliver findings for the complaint investigation. Due to COVID-19 and pre-cautionary measures, LPA wore a N95 mask throughout the visit. LPA met with Administrator Terri Aguiar and discussed the allegations. Throughout the course of the investigation, the Department reviewed facility notes, resident file, and conducted relevant party interviews, obtained relevant documentation and evidence.

The Department notes that the resident's were given a limited menu with choices for each meal at the time of the allegations. The facility fully trained staff before they began to work independently. Through staff interviews, the Department learned that R1 frequently walked in the courtyard where he accidentally dropped his wallet. There was no evidence of a specific amount of money in the wallet.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Melissa Lusby	TELEPHONE: (559) 580-5423
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2021

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 4

Control Number 27-AS-20200916120617

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: ALMOND HEIGHTS	FACILITY NUMBER: 342700525
	VISIT DATE: 05/26/2021

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32	Based on LPA's interviews and review of documentation, the preponderance of evidence standards was not met, therefore, the above allegations are found to be UNFOUNDED. An unfounded allegation means that the allegation was false, could not have happened and/or is without a reasonable basis. LPA Lusby conducted an exit interview.

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Melissa Lusby	TELEPHONE: (559) 580-5423
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2021

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 27-AS-20200916120617

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: ALMOND HEIGHTS	FACILITY NUMBER: 342700525
	VISIT DATE: 05/26/2021

NARRATIVE

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There was no evidence of resident being given the wrong medication, through staff interviews or documentation. Through interviews, the Department learned that R1 never pressed his pendant, so the facility implemented frequent checks in addition to his assistance with ADLs.

The Department finds the above noted allegations 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.

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Melissa Lusby	TELEPHONE: (559) 580-5423
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2021

LIC9099 (FAS) - (06/04)

Page: 4 of 4