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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700579
Report Date: 08/12/2020
Date Signed: 08/12/2020 04:51:02 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:CHATEAU AT RIVER'S EDGE, THEFACILITY NUMBER:
342700579
ADMINISTRATOR:MICHAEL TALANIFACILITY TYPE:
740
ADDRESS:641 FEATURE DRTELEPHONE:
(916) 921-1970
CITY:SACRAMENTOSTATE: CAZIP CODE:
95825
CAPACITY:143CENSUS: 90DATE:
08/12/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Administrator Mike TalaniTIME COMPLETED:
04:30 PM
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On 08/12/2020 Licensing Program Analysts (LPA) LPA McCrory and Wolter contacted the facility Administrator (Admin) Mike Talani to commence a Case Management Visit via phone due to COVID-19 and pre-cautionary measures. LPAs discussed the purpose of the call was to obtain further information on the LIC 624 Unusual Incident/Injury Report received 08/06/2020.

On 08/06/2020 received a LIC 624 Unusual Incident/Injury Report regarding complaints from a Resident (R1) involving inappropriate behavior from staff.

During the call Admin disclosed to LPAs the following:
  1. Admin states R1 confirmed no physical harm or touching.
  2. Admin states during questioning R1 described a time where there was multiple men in the room and then "spoke of rocks in the parking lot".
  3. Admin states Ombudsman felt that the R1 is confused and closed case.
  4. Admin states R1's room was flooded on 07/31/20 there was a fan in the room and security and maintenance extracting water from the apartment.
  5. Admin states R1 may be a candidate for memory care unit
  6. R1 was seen by Doctor and 602 Physicians Report is updated with a diagnosis of dementia
  7. Admin states facility is initiating more training regarding reporting

Admin Talani was advised that at this time possible follow-up telephone calls or visits may be necessary. LPA requested the following: documents from the internal investigation.

No deficiencies are cited at this time.
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Jasmine McCroryTELEPHONE: (916) 214-5020
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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