342700579-10-22-2021-27-AS-KHOS-C8EGSE-20211103053550

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700579
Report Date: 10/22/2021
Date Signed: 10/22/2021 04:27:08 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
09/03/2021 and conducted by Evaluator Mohamed Filouane

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20210903151406

FACILITY NAME:	CHATEAU AT RIVER'S EDGE, THE		FACILITY NUMBER:	342700579
ADMINISTRATOR:	MICHAEL TALANI		FACILITY TYPE:	740
ADDRESS:	641 FEATURE DR		TELEPHONE:	(916) 921-1970
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95825
CAPACITY:	143	CENSUS:	DATE:	10/22/2021
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Michael Talani		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff did not assist resident with their toileting needs in a timely manner.

INVESTIGATION FINDINGS:

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On 10/22/21, Licensing Program Analyst (LPA) Mohamed Filouane, conducted a 10-day complaint follow-up on-site inspection. LPA entered the facility and had his temperature taken and answered a COVID-19 questionnaire by a staff member, following the facility's health and safety procedures. LPA Filouane then met with Executive Director (ED) Michael Talani, explained the purpose of the visit, interviewed residents and staff, then delivered the findings of the investigation.

During the investigation, LPA Filouane interviewed the ED, interviewed residents, and staff regarding the allegation of staff not assisting a resident with their toileting needs in a timely manner. The report indicates that the resident in question (R1) waited approximately forty-five minutes for a staff member to assist them. LPA interviewed R1's neighbor and confirmed that R1 had explained the long waiting time for staff to their neighbor. LPA also interviewed the staff member who assisted R1 after they had waited for the alleged forty-five minutes. After review, this allegation is substantiated.

Based on LPA’s observations, record review, and interview, which were conducted along with a file review, the preponderance of evidence has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6 & Chapter number 8) is being cited on the attached LIC 9099D.

Exit interview conducted with the Executive Director. The Executive Director will receive a copy of this signed report through email.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Liza King	TELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Mohamed Filouane	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 27-AS-20210903151406

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: 10/22/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/29/2021 Section Cited CCR 87464(c)	1 2 3 4 5 6 7	Basic Services The admission agreement shall specify which of the basic services are desired and/or needed by, and will be provided for, each resident.	1 2 3 4 5 6 7	The Licensee shall ensure staff are trained to support and adhere to the agreed upon services of residents to maintain a healthy and safe environment. The Licensee shall submit a letter stating what the facility shall do to adhere to the requirements.
	8 9 10 11 12 13 14	This requirement has not been met as evidence by: the resident in question did not receive timely assistance in their daily nessecities as stated in their Needs and Appraisal plan and Adminission Agreement.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Liza King	TELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Mohamed Filouane	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 3

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
09/03/2021 and conducted by Evaluator Mohamed Filouane

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20210903151406

FACILITY NAME:	CHATEAU AT RIVER'S EDGE, THE		FACILITY NUMBER:	342700579
ADMINISTRATOR:	MICHAEL TALANI		FACILITY TYPE:	740
ADDRESS:	641 FEATURE DR		TELEPHONE:	(916) 921-1970
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95825
CAPACITY:	143	CENSUS:	DATE:	10/22/2021
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Michael Talani		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not assist resident with their showers.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 10/22/21, Licensing Program Analyst (LPA) Mohamed Filouane, conducted a 10-day complaint follow-up on-site inspection. LPA entered the facility and had his temperature taken and answered a COVID-19 questionnaire by a staff member, following the facility's health and safety procedures. LPA Filouane then met with Executive Director (ED) Michael Talani, explained the purpose of the visit, interviewed residents and staff, then delivered the findings of the investigation.

During the investigation, LPA Filouane interviewed the ED, reviewed requested documents, and interviewed residents. The ED denied the allegation. Resident interviews revealed no additional information on staff not assisting residents with showers. LPA reviewed the facility's pendant log and observed multiple instances when staff offered showers to the resident in question (R1), but according to the facility logs, R1 denied the shower services from staff. After review, this allegation is unsubstantiated.

The Department has investigated the complaint. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without reasonable basis.

Exit interview conducted with the Administrator. The Administrator will receive this LIC9099 report through email to sign. The Administrator will then email the signed version back to the LPA.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Liza King	TELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Mohamed Filouane	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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