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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700579
Report Date: 02/17/2021
Date Signed: 02/17/2021 10:33:59 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/28/2020 and conducted by Evaluator Bethany Huusfeldt
COMPLAINT CONTROL NUMBER: 27-AS-20201228152214
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: 75DATE:
02/17/2021
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Michael Talani, AdministratorTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Facility failed to meet residents needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bethany Huusfeldt spoke with Administrator Michael Talani over the phone to deliver findings due to COVID precautions.
LPA reviewed resident documents, facility documents, and interviewed residents and staff. Through interviews with relevant party, LPA found R1 was receiving continence care from a caregiver and then was left due to shift change. LPA interviewed R1, and R1 stated they were left by caregiver on the toilet during the shift change. R1 stated they were stuck in the bathroom for approximately 40 minutes until caregiver(C1) from the next shift found them. LPA interviewed C1 and C1 stated they reported for work on time and began to work on the floor. C1 stated no one from the prior shift informed them R1 was still in the bathroom. C1 was responding to call lights, and then went to check on R1.

Continuation on 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany HuusfeldtTELEPHONE: (916) 591-1072
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2021
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 6
Control Number 27-AS-20201228152214
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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, THE
FACILITY NUMBER: 342700579
VISIT DATE: 02/17/2021
NARRATIVE
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C1 found R1 on the toilet leaning against the wall. C1 stated R1 must have been on the toilet for at least 30 to 40 minutes before they found resident. C1 stated R1 requires full care in the bathroom, and is a fall risk. LPA reviewed R1’s documents. R1’s LIC602 stated resident requires assistance with their toileting needs. LPA reviewed R1’s needs and service plan, and observed R1 requires 1 person total assist to transfer and requires 1 person total assist with mobility and ambulation. In addition, the needs and service plan states R1 requires extensive incontinence checks and changes daily.
Due to the information gathered from interviews and record review, LPA finds allegation to be SUBSTANTIATED. A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met: Refer to the 9099-D.

Exit interview conducted and appeal rights given. Copy of report sent to administrator via email.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany HuusfeldtTELEPHONE: (916) 591-1072
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 27-AS-20201228152214
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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, THE
FACILITY NUMBER: 342700579
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/17/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
02/22/2021
Section Cited
CCR
87625(b)(2)
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87625 Managed Incontinence. (b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: (2) Ensuring that incontinent residents are checked during those periods of time when they are known to be incontinent, including during the night.
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Administrator agrees to conduct a training with staff concerning incontinence care. Date of training and training subject matter to be sent into CCL by 2/22/21.
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This requirement is not met as evidenced by: Based on interviews the licensee failed to check on incontinent resident during the time period of resident known to be incontinent which poses an immediate health risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany HuusfeldtTELEPHONE: (916) 591-1072
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/28/2020 and conducted by Evaluator Bethany Huusfeldt
COMPLAINT CONTROL NUMBER: 27-AS-20201228152214

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: 75DATE:
02/17/2021
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Michael Talani, AdministratorTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Food services are inadequate
Trash in residents' rooms are not being disposed of
Staff is not properly trained
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bethany Huusfeldt spoke with Administrator Michael Talani over the phone to deliver findings due to COVID precautions.
LPA reviewed resident documents, facility documents, facility menus, interviewed staff and residents, and conducted a tele-visit inspection. On 1/28/21 LPA conducted a tele-visit with administrator and toured the facility. LPA toured the kitchen area and observed refrigerator, freezer, and pantry. LPA observed 2-day perishable and 7-day non-perishable amount of food. LPA observed fruits, vegetables, breads, meats, and canned goods. LPA observed the meals for dinner which consisted of salmon and spaghetti, asparagus, garlic bread, and a 2nd choice was prime rib, mash potatoes and asparagus. In addition, LPA reviewed facility menus for the month of February. LPA observed several options for each meal which includes a vegetarian option, and a variety of vegetables and fruits.
Continuation on 9099-C.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany HuusfeldtTELEPHONE: (916) 591-1072
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 27-AS-20201228152214
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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, THE
FACILITY NUMBER: 342700579
VISIT DATE: 02/17/2021
NARRATIVE
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In addition, menu includes special items for each meal and a everyday option items. Due to the information gathered from record review and tele-visit inspection, LPA finds the allegation to be UNFOUNDED.

LPA investigated the allegation "Trash in residents' rooms are not being disposed of".
LPA reviewed facility documents, and interviewed residents and staff. Resident interviews indicate their trash is being taken out of their rooms on a daily basis however due to residents eating in their room and certain care needs, the trash should be taken out on a more regular basis. Staff interviews indicate caregivers should be taking out resident trash 1x per shift and as needed. Staff interviews indicate not all shifts regularly dispose of resident trash 1x per shift, however trash is taken out at least 1x daily. Interviews with administrator indicate trash is taken out of resident room by caregivers at least 1x per day and housekeeping cleans resident rooms weekly. LPA reviewed facility plan of operation and admission agreement, and did not find any policy or mention of how frequently the trash should be taken out of resident room. Due to the information gathered, resident trash is being disposed of daily concluding allegation to be UNFOUNDED.

LPA investigated the allegation "Staff is not properly trained". LPA reviewed staff training documents and interviewed staff. Review of staff training documents for 2020 indicate in-service training's are occurring monthly on several required topics. In addition, online training's, drills, and webinars are provided to care staff. LPA interviewed staff, and staff indicated training's are provided to them throughout the year in person and online. LPA observed sufficient hours of training and required subject matter. Due to record review LPA finds allegation to be Unfounded.

The allegation is 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. Copy of report sent to administrator via email.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany HuusfeldtTELEPHONE: (916) 591-1072
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/28/2020 and conducted by Evaluator Bethany Huusfeldt
COMPLAINT CONTROL NUMBER: 27-AS-20201228152214

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: 75DATE:
02/17/2021
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Michael Talani, AdministratorTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Facility has pests
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bethany Huusfeldt spoke with Administrator Michael Talani over the phone to deliver findings due to COVID precautions.

LPA reviewed facility documents and conducted interviews with staff and residents. LPA reviewed receipts from a exterminator company from April 2020 to January 2021. Receipts indicate there have been pests found and/or evidence of pests in facility, and the exterminator company has actively been treating the facility. LPA interviewed residents, and pests have been observed in the facility. Although there were/are pests in the facility, the facility is actively working to eradicate the pest issue. Due to the information gathered, LPA finds the allegation to be UNSUBSTANTIATED.

Exit interview conducted. Copy of report sent to administrator via email.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany HuusfeldtTELEPHONE: (916) 591-1072
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 6 of 6