342700936-5-22-2024-27-AS-KHOS-D64K4N-20240610073438

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700936
Report Date: 05/22/2024
Date Signed: 05/22/2024 04:39:14 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
02/06/2024 and conducted by Evaluator Arvin Villanueva

COMPLAINT CONTROL NUMBER: 27-AS-20240206105747

FACILITY NAME:	OFODIRE CARE HOME II		FACILITY NUMBER:	342700936
ADMINISTRATOR:	OFODIRE, PEARL		FACILITY TYPE:	735
ADDRESS:	9400 FEICKERT DRIVE		TELEPHONE:	(916) 230-0690
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	4	CENSUS: 3	DATE:	05/22/2024
		UNANNOUNCED	TIME BEGAN:	02:56 PM
MET WITH:	Pearl Ofodire		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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- Staff make resident stay in room.
- Staff are not allowing family to visit resident.

INVESTIGATION FINDINGS:

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On 5/22/24, at 2:56pm, Licensing Program Analyst (LPA) Arvin Villanueva arrived at this facility unannounced to conduct a follow up complaint visit regarding the allegations noted above and to deliver findings. LPA initially met with one of the staff on duty and explained the purpose of the visit. The administrator, Pearl Ofodire was notified and arrived shortly after. Present during this visit were 3 residents in care with 2 staff on duty.

Upon arrival to this facility, LPA observed 2 residents doing activities with one of the staff in the living room, and one resident was being assisted with shower with another staff on duty. At 3:50pm, residents and staff went to the backyard to do another activity. LPA also conducted additional interview and obtainedand revieweed additional documents.

{Con't to LIC9099-C}

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024

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-20240206105747

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: OFODIRE CARE HOME II	FACILITY NUMBER: 342700936
	VISIT DATE: 05/22/2024

NARRATIVE

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{Con't from LIC9099-A}

Allegation: Staff make resident stay in room:

Throughout this investigation, LPA conducted unannounced visits on 2/15/24, 5/15/24, and 5/22/24. LPA observed residents in care going in and out of their bedrooms and were roaming around the facility at various times. During a visit on 2/15/24, LPA observed Resident#1 (C1) and staff doing outdoor activities in the backyard. Per interview with staff on 2/15/24, C1’s preferred choice of activity is using their iPad. However, staff stated that they offer other activities to C1 such as helping with laundry, cleaning, wiping down tables, reading book to C1, coloring, listening to music, and exercise such as going for walks outside. Record reviews also indicated that C1 participates in community activities such as going to the park, shopping, going out for haircut and dining out.

Based on interviews, record reviews and observations, there is not a preponderance of evidence to conclude that staff make resident stay in their room. Therefore, this allegation is UNSUBSTANTIATED. A finding of UNSUBSTANTIATED means that although the violations may have occurred as reported the preponderance of evidence standard was not met.

Allegation: Staff are not allowing family to visit resident.

Throughout this investigation, LPA conducted records reviews and staff interviews. Per review of the facility’s visitors sign in log from 4/3/22 to 1/31/24, resident’s family members have visited residents in care as evidenced by the presence of signatures of visitors. Note that not all residents in care receive visitors on a regular basis and some do not received visitors at the facility. A review of C1’s documents indicated that C1 can receive visitors. Further review of C1’s documents revealed that visitations for C1 are required to be scheduled, supervised, and at a neutral place and not at the care facility. Based on interview, the administrator attempted to locate appropriate neutral places for where the visitation for C1 can take place such as at a police station. Based on interviews and record reviews, several attempts have been made to accommodate visitations for C1, including visitation via video conference. However, based on interviews and record reviews, these attempted or offered visits never took place due to C1's visitor not complying with the terms of the visit.

Based on interviews, and record reviews, there is not a preponderance of evidence to conclude that staff are not allowing family to visit resident. Therefore, this allegation is UNSUBSTANTIATED. A finding of UNSUBSTANTIATED means that although the violations may have occurred as reported the preponderance of evidence standard was not met.

An exit interview was conducted with Pearl Ofodire, administrator and a copy of this report and appeal rights were provided.

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024

LIC9099 (FAS) - (06/04)

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