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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700579
Report Date: 01/25/2024
Date Signed: 01/25/2024 03:50:25 PM

Substantiated


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
11/21/2023 and conducted by Evaluator Arvin Villanueva
COMPLAINT CONTROL NUMBER: 27-AS-20231121160532
FACILITY NAME:CHATEAU AT RIVER'S EDGE, THEFACILITY NUMBER:
342700579
ADMINISTRATOR:MUNDAY, PAMELAFACILITY TYPE:
740
ADDRESS:641 FEATURE DRTELEPHONE:
(916) 921-1970
CITY:SACRAMENTOSTATE: CAZIP CODE:
95825
CAPACITY:143CENSUS: 76DATE:
01/25/2024
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Marianne Richardson, Current Executive Director TIME COMPLETED:
12:00 PM
ALLEGATION(S):
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- Staff left resident soiled for an extended period.
- Staff did not ensure resident’s care needs were met in a timely manner.
- Staff did not ensure resident’s room was cleaned adequately.
- Staff did not maintain a comfortable room temperature for resident.
INVESTIGATION FINDINGS:
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On 1/25/2024 at 10:30am Licensing Program Analyst (LPA) Arvin Villanueva arrived at this facility unannounced to continue conducting a complaint investigation and to deliver findings for the allegations noted above. LPA Villanueva met with Marianne Richardson, current Executive Director (ED) and explained the purpose of the visit. Throughout this investigation, the LPA conducted facility observation, interviews, facility record review, staff record review, and resident record review.

During the course of the investigation, the Needs and Services Plan, LIC 602 and Admissions Agreement were reviewed for resident_1(R1). Staff_1 (S1) was interviewed as well as the interim Administrator and RP. During the investigation S1 was interviewed and it was disclosed and confirmed to LPA that the above allegations occurred to R1. Per S1, when there is a new resident, S1 would be in communication with family members of that resident and the facility staff including involved management. A face sheet would be created of the new resident that includes a photo of the resident, apartment number of that resident, the resident's diet/food preferences, move-in date and other facts about that resident.
{Con't to LIC9099-C}
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Stephen RichardsonTELEPHONE: (916) -26-4700
LICENSING EVALUATOR NAME: Arvin VillanuevaTELEPHONE: 916-558-2130
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2024
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 4
Control Number 27-AS-20231121160532
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: 01/25/2024
NARRATIVE
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{Con't from LIC9099}

The face sheet would then get distributed to staff including the management, care staff, med techs, and kitchen staff and would be posted in the medication room and the kitchen for staff to be aware of the new move in and residents needs. S1 further explained that they would post welcome signage at the new resident's apartment door before that resident moved in. S1 confirmed that R1 moved into the facility on a day that S1 was off, therefore the process explained above was not completed. S1 confirmed that staff were unaware that the resident was present at the facility. S1 confirmed that R1 was left unattended for a period of about 2-3 days. S1 confirmed the allegations occurred. Therefore, the above allegations are SUBSTANTIATED in which the preponderance of evidence standard has been met.

The following deficiencies were observed (see LIC 9099D) and cited from the California Code of Regulations, Title 22, and California Health and Safety Code. An immediate civil penalty in the amount of $500 is assessed in addition to the citations issued. Additional An immediate civil penalty in the amount of $250 is assessed in addition to the citations issued due to a repeat violation. These incidents are currently under review and a future civil penalty may apply based on 1569.49(f) H&S. Failure to correct the deficiencies may also result in civil penalties.

An exit interview was conducted with Marianne Richardson (ED) and a copy of this report and appeal rights were provided.
SUPERVISOR'S NAME: Stephen RichardsonTELEPHONE: (916) -26-4700
LICENSING EVALUATOR NAME: Arvin VillanuevaTELEPHONE: 916-558-2130
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 27-AS-20231121160532
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/26/2024
Section Cited
CCR
87464(f)(1)
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87464(f)(1) Basic Services: Basic services shall at a minimum include: Care and supervision as defined in Section 87101(c)(3) (f) and Health and Safety Code section 1569.2(i).
This requirement is not met as evidenced by:
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Licensee to submit a written care plan on how the facility will provide adequate care and supervision for new move in residents. The facility shall submit the care plan to Licensing by POC due date of 1/26/2024.
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Based on records review and interviews, the licensee did not ensure care and supervision needs were provided in a timely manner to R1 which resulted in absence of care and supervision longer than one day. This poses/posed an immediate health and safety risks to resident in care
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Licensee to provide staff training on the procedure of the care plan for new move in residents. Licensee to submit the date of the training by POC due date.
Licensee to submit proof of staff training once completed.
Type B
02/01/2024
Section Cited
CCR
87303(b)(1)
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87303 Maintenance and Operation: (b) A comfortable temperature for residents shall be maintained at all times. (1) The facility shall heat rooms that residents occupy to a minimum of 68 degree F, (20 degrees C).
This requirement is not met as evidenced by:
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Licensee to include in the staff training on the subject of maintaining comfortable temparature for residents per regulation. Licensee to submit the date of the training by POC due date.
Licensee to submit proof of staff training once completed.
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Based on interviews and document review, the licensee did not ensure R1’s apartment unit was maintained at a comfortable room temperature at a minimum of 68 degrees F which poses/posed a potential health and safety risk to resident 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: Stephen RichardsonTELEPHONE: (916) -26-4700
LICENSING EVALUATOR NAME: Arvin VillanuevaTELEPHONE: 916-558-2130
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 27-AS-20231121160532
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/01/2024
Section Cited
CCR
87303(a)
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87303 Maintenance and Operation: (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
This requirement is not me as evidenced by:
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Licensee to include in the staff training on the subject of keeping facility clean, safe, sanitary, and in good repair per regulation. Licensee to submit the date of the training by POC due date.
Licensee to submit proof of staff training once completed.
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Based on record review and interview, R1 was left unattended for an extended period of time. As a resulted the licensee did not ensure R1’s apartment unit was cleaned adequately which poses/posed a potential health and safety risk to resident in care.
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Type B
02/01/2024
Section Cited
CCR
87625(b)(3)
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87625(b)(3) ... the licensee shall be responsible for ... Ensuring that incontinent residents are kept clean and dry and ... the facility remains free of odors from incontinence.

This requirement is not met as evidenced by
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Licensee to include in the staff training on the subject of incontinence care for residents per regulation. Licensee to submit the date of the training by POC due date.
Licensee to submit proof of staff training once completed.
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Based on interviews and record review, R1 was left unattended for an extended period of time. As a resulted, the licensee did not ensure R1 was provided incontinent care which left R1 being soiled for an extended time. This poses/posed a potential health and safety 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: Stephen RichardsonTELEPHONE: (916) -26-4700
LICENSING EVALUATOR NAME: Arvin VillanuevaTELEPHONE: 916-558-2130
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 4