342700650-1-17-2025-59-AS-MSEY-DDBQNJ-20250127111913

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700650
Report Date: 01/17/2025
Date Signed: 01/17/2025 05:28:51 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH 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
10/22/2024 and conducted by Evaluator Angela Hood

COMPLAINT CONTROL NUMBER: 59-AS-20241022151840

FACILITY NAME:	MERAKEY - PARKS		FACILITY NUMBER:	342700650
ADMINISTRATOR:	KYRIE S RICHARDSON		FACILITY TYPE:	737
ADDRESS:	3333 PARKS LANE		TELEPHONE:	(916) 609-2425
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	4	CENSUS: 4	DATE:	01/17/2025
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Kyrie Richardson, Administrator		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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-Staff did not provide adequate supervision to a client
-Staff did not properly report an incident involving a client
-Staff do not have planned activities for the clients
-Staff do not ensure a client is properly fed
-Staff did not seek timely medical attention
-Staff behavior posed as a risk to the clients

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angela Hood arrived at the care home today, 1/17/25, and met with the Administrator, Kyrie Richardson, to deliver complaint investigation findings regarding the above stated allegations.

During the course of the investigation, LPA conducted interviews and obtained documentation pertinent to the investigation.

Allegation: Staff did not provide adequate supervision to a client
Relevant party reported that during the NOC shift resident (R4) went missing and was either found or broke into Starbucks. Interview with Administrator indicated that R4 has not gone AWOL since they have worked at the care home. Interviews with staff (S1, S3, S4, S5, S6, and S7) indicated that they have not heard of any incidents where R4 went missing or AWOL from the facility and did not believe the incident occurred.
************************************************Continued on LIC9099-C**************************************************

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

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 59-AS-20241022151840

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MERAKEY - PARKS	FACILITY NUMBER: 342700650
	VISIT DATE: 01/17/2025

NARRATIVE

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Allegation: Staff did not properly report an incident involving a client
Relevant party reported that the facility did not report when R4 went missing or AWOL from the facility. According to interviews with the Administrator, S1, S3, S4, S5, S6, and S7, the incident did not occur. No incident was reported to the Department.

Allegation: Staff did not have planned activities for the clients
During visits conducted on 10/24/24 and 1/17/25, LPA observed resident’s (R1, R2, and R3) and R4’s weekly activity calendars and daily programming outlines, which indicated what the residents will be doing throughout each day of the week. According to R1, R2, R3, and R4’s Individualized Support Plans for December 2024, all residents participated in activities throughout the month. Interviews with Administrator, S1, S3, S4, S5, S6, and S7, indicated that all residents go on outings and participate in activities frequently. Relevant party reported that R4 is taken on van rides and falls asleep while staff continue to drive around. Interviews with S4 and S7 indicated that, if a resident falls asleep on a van ride, they take the resident home. Interviews with S1, S4, S5, S6, and S7 indicated that they have never witnessed R4 fall asleep on a van ride. Staff interviews also indicated that all residents are alert while in the van.

Allegation: Staff do not ensure a client is properly fed
Relevant party reported that R2 is missing meals and has gone days without food. Interviews with Administrator, S1, S3, S4, S5, S6, and S7 indicated that R2 is provided meals and is eating. Interviews also indicated that R2 tends to eat more food during the NOC shift and is eating daily. Staff indicated that, although R2 eats more during the NOC shift, they are provided three meals a day and snacks throughout the day as well.

Allegation: Staff did not seek timely medical attention
Relevant party reported that a resident (unknown) was in a car accident, hit their head, and was not taken to receive medical treatment. Interview with the Administrator indicated that there have not been any car accidents since they have worked at the home. Interviews with S1, S3, S4, S5, S6, and S7 indicated that none of the residents were involved in any car accidents. No incident was reported to the Department.

************************************************Continued on LIC9099-C**************************************************

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

LIC9099 (FAS) - (06/04)

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Control Number 59-AS-20241022151840

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MERAKEY - PARKS	FACILITY NUMBER: 342700650
	VISIT DATE: 01/17/2025

NARRATIVE

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Allegation: Staff behavior posed as a risk to the clients
Relevant party reported that possibly staff (S10) arrived at the care home intoxicated and was behaving inappropriately. Interviews with Administrator, S1, S3, S4, S5, S6, and S7 indicated that S10 has never been intoxicated in the facility. Staff indicated that S10 is responsible, helpful, and would never do that.

Based on records reviewed, interviews conducted, and observation, although the allegations may have happened 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. No deficiencies are being cited.

Exit interview conducted. A copy of the report was provided.

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

LIC9099 (FAS) - (06/04)

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