342701040-10-31-2023-27-AS-KHOS-CXBM5N-20231106081837

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342701040
Report Date: 10/31/2023
Date Signed: 10/31/2023 03:08:43 PM

Unsubstantiated

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
10/23/2023 and conducted by Evaluator Christina Valerio

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20231023110153

FACILITY NAME:	BRUCEVILLE POINT		FACILITY NUMBER:	342701040
ADMINISTRATOR:	HOSTETTER, ERIC		FACILITY TYPE:	740
ADDRESS:	9730 BACKER RANCH ROAD		TELEPHONE:	(916) 226-5300
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95757
CAPACITY:	200	CENSUS: 133	DATE:	10/31/2023
		UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Eric Hostetter		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff stealing residents personal belongings.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Christina Valerio and LPA Arvin Villanueva arrived unannounced to the home to conduct a 10-Day Visit/Complaint Investigation. LPAs were met by Administrator Eric Hostetter, and explained the purpose of the visit. LPAs obtained copies of Resident Roster, Staff Schedule, and Theft and Loss Records.

LPAs interviewed Facility Staff (S1 - S4), a family member (FM), and Residents (R1 - R7). Based on interviews, S1 stated there have been reports of items missing. S1 stated the facility maintains a Theft and Loss Record for any items reported missing, stolen, or loss. In addition, the facility reports the items missing to the Elk Grove Police Department. LPA obtained copies for reference. S2 and S3 stated residents have told them items go missing; however, they have not taken any items. S2 and S3 go inside resident rooms while residents are present and at times where residents are not in the room. S4 stated a resident reported missing items and S4 does not know if the items have been recovered.
Continues on LIC 9099 - C...

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Christina Valerio	TELEPHONE: 916-823-6323
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2023

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-20231023110153

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: BRUCEVILLE POINT	FACILITY NUMBER: 342701040
	VISIT DATE: 10/31/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Continued from LIC 9099

LPAs interviewed a Family Member (FM). FM stated that there have been no reports of any items missing from their loved one's room. FM stated that housekeeping comes to the room once per week and staff check on the resident daily. LPAs interviewed 7 residents. 3 out of 7 resident interviews were deemed unsuccessful. Out of the 4 resident interviews deemed successful, 3 out of 4 residents did not have any concerns with staff stealing resident belongings. One resident stated they have heard about other resident's belongings being taken but have not personally experienced it. Another resident stated that there have been a few instances where small items have been missing and then magically reappeared when the resident asked management about the items.

During the investigation, LPAs obtained copies of the Resident Theft and Loss Record. Records show that there have been 3 reports filed in the last 3 months. Records were obtained for reference.

Based on all the information collected by the Department, there is not a preponderance of evidence to prove the allegation occurred, therefore this allegation is UNSUBSTANTIATED. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies cited. Exit interview was held, and a copy of report was provided.

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Christina Valerio	TELEPHONE: 916-823-6323
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2