342700579-12-14-2023-27-AS-SRIN-CYXT3B-20231228132204

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700579
Report Date: 12/14/2023
Date Signed: 12/14/2023 04:26:49 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/14/2023 and conducted by Evaluator Vincent Moleski

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20231114075826

FACILITY NAME:	CHATEAU AT RIVER'S EDGE, THE		FACILITY NUMBER:	342700579
ADMINISTRATOR:	MUNDAY, PAMELA		FACILITY TYPE:	740
ADDRESS:	641 FEATURE DR		TELEPHONE:	(916) 921-1970
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95825
CAPACITY:	143	CENSUS: 84	DATE:	12/14/2023
		UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Xochitl Vuittonet		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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The facility elevator is in disrepair.
Facility staff do not provide adequate food service to residents in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to investigate this complaint. LPA Moleski met with memory care director Xochitl Vuittonet and explained the purpose of the visit.

This investigation consisted of interviews, observation, and record review.

LPA Moleski used the facility elevator during visits on 11/20/23 and 12/14/23. The elevator worked during these visits.

During an interview, a former facility administrator said that the facility elevator started having issues on the morning of November 11, 2023. The administrator said that an elevator technician was called on Saturday, but parts for the elevator were not available over the holiday weekend. The administrator said that the elevator buttons did not immediately work, and needed to be pressed multiple times. [continued on 9099-C]

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Vincent Moleski	TELEPHONE: (559) 365-5294
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

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 3

Control Number 27-AS-20231114075826

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CHATEAU AT RIVER'S EDGE, THE	FACILITY NUMBER: 342700579
	VISIT DATE: 12/14/2023

NARRATIVE

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The administrator said the elevator was not used over the weekend to prevent anyone from getting stuck inside. The administrator said the elevator was available for use for emergencies, if needed. The administrator said the elevator was repaired on November 13, 2023. The administrator said that meals were delivered to any residents who did not want to come downstairs.

LPA Moleski reviewed an email sent by the former facility administrator to the Community Care Licensing Division on November 12, 2023. In the email, the administrator said the elevator was having “technical issues,” and that “we are able to use it” but “we made an executive decision to not use it until it can get fully repaired on Monday [November 13, 2023]”.

LPA Moleski reviewed a work report from an elevator maintenance company. The report details service through the period of November 11, 2023 and November 15, 2023. According to the report, the elevator buttons were lighting up but would then turn off as of November 11, 2023. The report describes service being performed on November 13, 2023. The elevator had returned to service as of November 15, 2023, according to the report.

LPA Moleski interviewed four staff members (S1-S4). In an interview, the facility maintenance director (S1) said S1 was first aware of the elevator issues as of November 10, 2023. At that time, the elevator’s button lights would turn off after being pressed, but would work if pressed repeatedly. According to S1, an elevator maintenance company was called on November 11, 2023. S1 said the elevator was fully operational as of the morning of November 14, 2023.

LPA Moleski interviewed four residents (R1-R4). In an interview, R1 said food was delivered while the elevator was not being used. R1 said staff were “very good” about delivering food. R1 said R1 had no concerns regarding the food service while the elevator was not being used. LPA Moleski reviewed food service sheets dated between November 11, 2023 and November 13, 2023. According to the sheets, R1 was not served any meals during this time. In an interview, R1 said R1 had some food delivered, and said R1 had plenty of food in R1’s room. LPA Moleski reviewed R1’s LIC 602. R1 is ambulatory, according to the LIC 602.

[continued on 9099-C]

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Vincent Moleski	TELEPHONE: (559) 365-5294
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 27-AS-20231114075826

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CHATEAU AT RIVER'S EDGE, THE	FACILITY NUMBER: 342700579
	VISIT DATE: 12/14/2023

NARRATIVE

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In an interview, the facility’s dining room manager (S2) said that R1 often refuses meal service, and that R1 prefers R1’s own food. S2 said there were no issues with food deliveries during the time the elevator was not being used. In an interview, S3 said there were no issues getting meals delivered to residents on November 12, 2023. S4 did not recall any issues with food service on November 13, 2023.

In interviews, R2-R4 did not share any concerns regarding food service during the time the elevator was not being used. R3 said R3 was helped downstairs by a friend, and said that the elevator was available for use for emergencies. R3 said R3 used the elevator while it was not in general operation. R4 said R4 was carried upstairs in a wheelchair by paramedics while the elevator was not being used.

The department has determined the following as it relates to the allegations that the facility elevator is in disrepair and that facility staff do not provide adequate food service to residents in care:

Based on interviews, observation, and record review, the above allegations are UNSUBSTANTIATED, which means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

No deficiencies were cited during this visit. An exit interview was held and a copy of this report was left with Vuittonet.

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Vincent Moleski	TELEPHONE: (559) 365-5294
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

LIC9099 (FAS) - (06/04)

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