342700597-3-14-2022-27-AS-CACL-CCQULQ-20220321154107

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700597
Report Date: 03/14/2022
Date Signed: 03/14/2022 03:04:39 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
02/14/2022 and conducted by Evaluator Christopher Hopkins-Clarke

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20220214101435

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:	0	CENSUS: 0	DATE:	03/14/2022
		UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Melissa Orello		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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-Staff are not following the resident's care plan
-Resident's personal hygiene needs are not being met
-Facility is understaff
-Facility is not providing adequate amount of food, snacks, or water throughout the day

INVESTIGATION FINDINGS:

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On March 14, 2022 at 1:40 PM, Licensing Program Analyst (LPA) Chris Hopkins conducted an unannounced facility visit in regards to a complaint investigation with the above allegations. A risk assessment call was performed prior to entry verifying there were no active covid cases. LPA Hopkins met with Executive Director Melissa Orello and explained the purpose of today's visit.

Regarding the allegation of Staff are not following the resident's care plan, the Department found the following: based on interview and record review, it was determined staff are observing Resident 1's (R1) skin condition daily. R1's care plan states "monitor for skin breakdown", staff have been monitoring daily.

Regarding the allegation of Resident's personal hygiene needs are not being met, the Department found the following: based on interview and observation, it was determined that R1's dentures were cleaned nightly, sometimes they would be cleaned in the mornings as well.
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: 03/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2022

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-20220214101435

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: 03/14/2022

NARRATIVE

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LPA observed R1's toenails on 2/18/22 and they appeared to be shorter than 6 inches. LPA would say they were about 2-3 inches long. Staff did state that R1 had an ingrown toenail.

Regarding the allegation of Facility is understaff, the Department found the following: based on interview and record review, it was determined that the day R1's responsible party came to visit R1, 1 staff did call off sick, but the facility shifts were all still covered. There were 2 caregivers and 1 med tech for memory care.

Regarding the allegation of Facility is not providing adequate amount of food, snacks, or water throughout the day, the Department found the following: based on interview and record review, it was determined that the facility provides breakfast, morning snack, lunch, afternoon snack, and dinner. Staff stated that lunch was never served at 3:30, it was served around 12:30 or 1pm. LPA obtained a menu from the week of 2/13/22- 2/19/22 and all meals look to be adequate.

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: 03/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2022

LIC9099 (FAS) - (06/04)

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