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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700850
Report Date: 03/24/2023
Date Signed: 04/13/2023 10:19:37 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO AC/SC, 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
01/09/2023 and conducted by Evaluator Renee Campbell
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20230109164838
FACILITY NAME:TWIN CITIES BOARD & CARE HOMEFACILITY NUMBER:
342700850
ADMINISTRATOR:LINDA MUSTINFACILITY TYPE:
735
ADDRESS:11098 TWIN CITIES ROADTELEPHONE:
(209) 745-4380
CITY:GALTSTATE: CAZIP CODE:
95632
CAPACITY:15CENSUS: 15DATE:
03/24/2023
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Linda MustinTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Staff speak inappropriately to residents in care.
Staff not providing adequate food service.
Facility is not following COVID protocols.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Renee Campbell visited the facility and conducted an unannounced facility visit to deliver investigation findings on 03/24/2023. LPA identified herself and discussed the purpose of the visit and the elements of the allegations with licensee. Throughout the course of the investigation, LPA Campbell toured facility on two separate unannounced visits, observed meals being prepared on 2 occasions, conducted interviews of 12 residents, 2 staff and reviewed facility documents including food receipts . During the investigation, LPA observed surroundings, residents and staff, with no instances of staff speaking disrespectfully to residents. 12 of 12 Residents reported they were satisfied with their care. Moreover, when residents were surveyed, none reported dissatisfaction with food or staff treatment. 2 of 2 staff interviewed reported they had not witnessed staff speaking disrespectfully to residents.
Menus reflected meals that were nutritionally sufficient and matched the menus. LPA toured the food pantry, outdoor freezer and refrigerator. There were more than enough non-perishable foods for the 15 residents. There were 2 days of perishable food present. 9099-cont
This report was amended on 04/12/23
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Emerita Curiel
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
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 2
Control Number 27-AS-20230109164838
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO AC/SC, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: TWIN CITIES BOARD & CARE HOME
FACILITY NUMBER: 342700850
VISIT DATE: 03/24/2023
NARRATIVE
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cont. 9099

Staff greeted LPA with masks during both facility visits, scanned for fever and instituted sign in procedures. Due to the above noted information, 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, and therefore the allegations are unsubstantiated. Per California Code of Regulations (CCRs) - Title 22, Division 6, no deficiencies cited. An exit interview was conducted with and a copy of this report was provided.
SUPERVISORS NAME: Emerita Curiel
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2