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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700579
Report Date: 05/20/2021
Date Signed: 06/08/2021 02:11:45 PM



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
04/12/2021 and conducted by Evaluator Tirzah Hubbard
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20210412161537
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: 76DATE:
05/20/2021
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Micheal TalaniTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Facility elevator is in disrepair.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA)s Tirzah Hubbard and Charlie Yang conducted an unanounced complaint visit to conclude the complaint investigation due to COVID-19 and pre-cautionary measures with facility Executive Director Micheal Talani. Current census of the facility was: 76

The purpose of the visit was to complete this complaint investigation and deliver the findings to this facility. Based on interviews and information gathered during the course of the investigation, it was learned that the elevator was in disrepair for an hour. Based on interview with Executive Director Micheal Talani he stated that the elevator was in disrepair for an hour.

87303 Maintenance and operation
(a) The facility shall be clean, safe, sanitary and in good repair at all times.
Substantiated
Estimated Days of Completion: 30
SUPERVISOR'S NAME: Stephen RichardsonTELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Tirzah HubbardTELEPHONE: 559-365-5294
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2021
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 3
Control Number 27-AS-20210412161537
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: 05/20/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/11/2021
Section Cited
CCR
87303(a)
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87303(a) 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.
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Licensee agreed to have elevator repaired and it was operational within 1 hour. Licensee submitted receipt that the repair was completed, and LPA observed the elevator in working order on 4-11-21. No further action required.
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This regulation was not met as evidence by:Based on LPA’s interview with Administrator and review of documents Licensee did not ensure the health and safety of residents in care due to elevator in disrepair. This poses as a potential 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) 263-4746
LICENSING EVALUATOR NAME: Tirzah HubbardTELEPHONE: 559-365-5294
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20210412161537
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: 06/07/2021
NARRATIVE
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Based on interviews and information gathered facility was deficient as evidence by admission by the Executive Director stating that the elevator was in disrepair for an hour. This facility did not make sure that the facility was in compliance which posed a potential risk to the health, safety, and personal rights of the residents in care.

The following deficiency was delivered and cited on the following LIC 9099-D Pursuant to Title 22 Rules and Regulations.

The preponderance of evidence standards has been met. Therefore, the allegation was deemed to be Substantiated. " The agency has investigated the complaint alleging, the above-mentioned allegation. This agency has found that the complaint was Substantiated meaning that the allegation was true, could have happened and/or was with reasonable basis. We have therefore substantiated the complaint".

Before the exit interview, appeal rights were printed and discussed with the facility designated Executive Director Michael Talani.

Exit interview.
SUPERVISOR'S NAME: Stephen RichardsonTELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Tirzah HubbardTELEPHONE: 559-365-5294
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2021
LIC9099 (FAS) - (06/04)
Page: 1 of 2