342700534-12-16-2021-25-AS-MSEY-C9VPLL-20211220102452

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700534
Report Date: 12/16/2021
Date Signed: 12/16/2021 02:16:10 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
09/20/2021 and conducted by Evaluator Sabrina Calzada

PUBLIC

COMPLAINT CONTROL NUMBER: 25-AS-20210920145857

FACILITY NAME:	SPLENDOR OF CARMICHAEL AT KEANE, THE		FACILITY NUMBER:	342700534
ADMINISTRATOR:	FOGGY, BRUCE		FACILITY TYPE:	740
ADDRESS:	4921 KEANE DRIVE		TELEPHONE:	(916) 514-9173
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	6	CENSUS: 6	DATE:	12/16/2021
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:			TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff are severely limiting visiting hours for residents

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to complete the investigation and deliver findings to a complaint the Department received on 09/20/2021. LPA met with Doreen, caregiver, who contacted the Administrator/House Manager, Maria Williams, who arrived at 2:00 pm to the facility. Caregiver on site confirmed there are (6) residents currently, and there are no residents on hospice. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols and completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. LPA observed (2) residents to be napping on the couch in the front room and (4) residents to be napping in their rooms.

During the course of the investigation, the Department interviewed the Administrator and House Manager and reviewed documentation, including, but not limited to, visitor signs posted at the front entrance, Personal Rights (LIC613-C), House Rules, Department Provider Information Notices (PIN), and visitor logs.

The results of the investigation are as follows: The complaint alleges that, on/around September 20, 2021, the facility posted signs stating the visiting hours are from 10:00-11:00 AM and from 2:00-4:00 PM only, there are no visits allowed after 5 pm, and there is only 1 person at a time for 20 minutes maximum.

cont on 9099-C..

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina Calzada	TELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2021

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-20210920145857

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: SPLENDOR OF CARMICHAEL AT KEANE, THE	FACILITY NUMBER: 342700534
	VISIT DATE: 12/16/2021

NARRATIVE

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9099-C (1).LPA observed several signs to be posted outside the front entrance on 9/29/2021 when conducting the 10-day inspection. One sign, dated 9/14/2021, read: Attention to all family members and friends: As of today, we are limiting the visits to one person per resident, for 20 minutes per day only.
A second sign read: Attention Visitors -Visiting Hours are 10:00 am- 11:00 am and 2:00-pm to 4:00 pm and there are no visitors after 4:00 pm. The sign also provides manager contact information for any questions. LPA observed a third sign (orange), to also be posted that said "No Visitors Allowed".

House Manager stated in an interview that the facility made changes to visiting hours due to too many visitors coming to the facility all at once and also during resident meal times. House Manager stated that she informed residents and their family members, verbally, prior to implementing the changes and confirmed that the visiting restrictions apply to indoor visits only, and she encourages outdoor visitation as much as possible. House Manager stated on 9/29/2021 that she had not received any calls regarding anyone wanting to visit outside of the posted hours and stated on 11/17/2021 that they "never denied visitation" to anyone.

The Administrator stated in an email, on 11/16/2021, that the visiting hours posted were "merely guidelines for families who come during breakfast, lunch or dinner time and have been revised to reflect only those time periods and that they only request that visitors don't visit during meal times as the residents really enjoy their time with other residents." Additionally, the Administrator stated on 11/17/2021 that the visiting hours were revised the same day the complaint was opened, on 9/29/2021.

LPA reviewed department- issued Covid-19 guidance regarding visitation pursuant to PIN 21-17.2 dated 5/14/2021, which states under "Best Practices" to reduce the risk of Covid-19 transmission during visitation- "Limit the number of visitors on the facility premises at any one time to avoid having large groups congregate" and to "Encourage shorter indoor visits and longer outdoor visits".

On 12/16/2021, LPA reviewed the visitor logs for October 2021 through the current date and observed that many residents had more than (1) visitor on some days and that the visits varied in length, with many visits lasting 45 minutes to two hours. LPA observed three of the posters that were previously posted to have been removed from the front entrance.

Based on information obtained and no specific date/time provided to the Department as to when/if visitation was restricted, LPA finds the allegation to be UNSUBSTANTIATED- A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview. Copy of report to be e-mailed to the Administrator

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina Calzada	TELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2021

LIC9099 (FAS) - (06/04)

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