342700525-7-8-2021-25-AS-LMUZ-C4VPCX-20210713111240

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700525
Report Date: 07/08/2021
Date Signed: 07/08/2021 02:47:19 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
07/01/2021 and conducted by Evaluator Melissa Lusby

PUBLIC

COMPLAINT CONTROL NUMBER: 25-AS-20210701155204

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:	DATE:	07/08/2021
		UNANNOUNCED	TIME BEGAN:	10:49 AM
MET WITH:	Terri Aguiar		TIME COMPLETED:	10:50 AM

ALLEGATION(S):

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Facility is in disrepair

INVESTIGATION FINDINGS:

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LPA Lusby arrived on Thursday July 8, 2021 to open a complaint investigation regarding the appove allegation. Prior to the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 mask.

Throughout the course of the investigation, LPA Lusby conducted a document review, toured the facility, and interviewed relevant parties. While one (out of 16) of the air conditioners is currently in the process of being replaced, the facility is ensuring that the common areas stay at a comfortable level. The facility produced evidence that they acted appropriately and timely when the air conditioner malfunctioned. Therefore, the Department has determined that this allegation is unsubstantiated.

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Melissa Lusby	TELEPHONE: (559) 580-5423
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021

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
07/01/2021 and conducted by Evaluator Melissa Lusby

PUBLIC

COMPLAINT CONTROL NUMBER: 25-AS-20210701155204

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:	07/08/2021
		UNANNOUNCED	TIME BEGAN:	10:49 AM
MET WITH:	Terri Aguiar		TIME COMPLETED:	10:50 AM

ALLEGATION(S):

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Facility does not have specialized menu/diabetic menu to meet resident's needs

INVESTIGATION FINDINGS:

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LPA Lusby arrived on Thursday July 8, 2021 to open a complaint investigation regarding the appove allegation. Prior to the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 mask.

Throughout the course of the investigation, LPA Lusby reviewed the facility's menu and interviewed relevant parties. The facility has a weekly cycle menu which offers two entree choices for lunch and dinner. The facility additionally has an always available menu available to all residents. This menu includes specialized diabetic desserts. The Department has determined that the above allegation is unfounded.

Unfounded

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Melissa Lusby	TELEPHONE: (559) 580-5423
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021

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 25-AS-20210701155204

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: 07/08/2021

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 LPAs interviews and review of documentation, 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. LPA Lusby conducted an exit interview. A copy of this report was left at the facility.

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Melissa Lusby	TELEPHONE: (559) 580-5423
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 25-AS-20210701155204

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: 07/08/2021

NARRATIVE

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The Department finds the allegation of facility in disrepair 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 interview conducted. A copy this report was left at the facility. Appeal rights were given.

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Melissa Lusby	TELEPHONE: (559) 580-5423
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021

LIC9099 (FAS) - (06/04)

Page: 4 of 4