342700525-9-8-2021-25-AS-LMUZ-C6TR63-20210913124403

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700525
Report Date: 09/08/2021
Date Signed: 09/08/2021 12:41:45 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
07/29/2021 and conducted by Evaluator Danyle Wolter

PUBLIC

COMPLAINT CONTROL NUMBER: 25-AS-20210729144522

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: 97	DATE:	09/08/2021
		UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Terri Aguiar, Executive Director		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Staff is not following resident special diet.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Wolter contacted the facility by telephone on 09/08/2021 due to COVID-19 and precautionary measures to deliver complaint findings for allegation listed above, LPA spoke to Executive Director Terri Aguiar and explained the purpose of the call.

Throughout the course of the investigation the department reviewed documentation and conducted interviews relevant to the allegation: staff is not following resident special diet. Documentation reviewed and interviews conducted revealed that the facility has a list of residents’ with special diets listed in the kitchen, menu’s posted daily, and an always available menu as an alternative to daily specials. Residents (R1) medical assessment was reviewed and no special diet was noted for R1.

Report continued on LIC 9099-C

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Danyle Wolter	TELEPHONE: (916) 708-5307
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021

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 25-AS-20210729144522

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: 09/08/2021

NARRATIVE

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Additionally, the department conducted a similar complaint investigation alleging the facility did not have a specialized menu/diabetic menu to meet resident’s needs in July 2021 which was found to be unfounded.

Due to this information the department finds the allegation to be UNFOUNDED - A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview conducted and copy of report emailed to Executive Director. Executive Director to send a signed copy back to Community Care Licensing, a signed copy should also be retained for facility records.

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Danyle Wolter	TELEPHONE: (916) 708-5307
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021

LIC9099 (FAS) - (06/04)

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