342700597-2-14-2022-27-AS-KHOS-CCCKV3-20220309071341

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700597
Report Date: 02/14/2022
Date Signed: 02/14/2022 11:48:12 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
11/29/2021 and conducted by Evaluator Christopher Hopkins-Clarke

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20211129113549

FACILITY NAME:	LEGACY OAKS OF SACRAMENTO		FACILITY NUMBER:	342700597
ADMINISTRATOR:	MELISSA ORELLO		FACILITY TYPE:	740
ADDRESS:	1922 MORSE AVENUE		TELEPHONE:	(916) 482-7745
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95825
CAPACITY:	160	CENSUS: 51	DATE:	02/14/2022
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Melissa Orello		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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-Unqualified staff dispensing medication
-Staff mismanages residents' medication
-Staff do not accord dignity in their relationship with residents

INVESTIGATION FINDINGS:

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On 2/14/2022 at 9:45 AM, Licensing Program Analyst (LPA) Chris Hopkins arrived at this facility unannounced to conduct a complaint investigation regarding the above allegations. LPA met with Executive Director Melissa Orello and explained the purpose of today's visit.

Regarding the allegation of Unqualified staff dispensing medication, the Department found the following: based on interview and record review, it was determined the only staff that dispense medication are the Med-Techs. LPA recieved and reviewed Med-Tech training logs. LPA also checked staff association, and all Med-Techs are associated to this facility. LPA interviewed residents and staff, both parties say only Med-Techs distribute medication.

Report Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Czarrina A Camilon-Lee	TELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Christopher Hopkins-Clarke	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2022

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-20211129113549

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: LEGACY OAKS OF SACRAMENTO	FACILITY NUMBER: 342700597
	VISIT DATE: 02/14/2022

NARRATIVE

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Regarding the allegation of Staff mismanages residents' medication, the Department found the following: based on interview, it was determined that Med-Techs are dispensing medication on time and are following the MAR dispensing the correct medication. There is a schedule in dispensing meds which is 8am, 12pm, 5pm, 8pm, and 10pm. Med-Techs are able to dispense a hour before or a hour after those times. LPA interviewed 8 residents, residents state they never have a problem with any of their medications.

Regarding the allegation of Staff do not accord dignity in their relationship with residents, the Department found the following: based on interview, it was determined that Staff 1 (S1) and Staff 2 (S2) never passed any marijuana to each other. S2 was interviewed and denied being verbally abusive to any residents. Residents were interviewed and stated the same thing, S2 has never been verbally abusive, rude, or mean. Residents state that they like S2.

LPA has deemed the complaint findings as UNSUBSTANTIATED. Although the allegations may have happened and/or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview conducted with Executive Director Melissa Orello. A copy of this report was left with facility upon exit.

SUPERVISOR'S NAME: Czarrina A Camilon-Lee	TELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Christopher Hopkins-Clarke	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2022

LIC9099 (FAS) - (06/04)

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