342701122-12-12-2023-27-AS-KHOS-CZ6KQY-20240104070708

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342701122
Report Date: 12/12/2023
Date Signed: 12/12/2023 12:21:05 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
11/21/2023 and conducted by Evaluator Kimberly Viarella

COMPLAINT CONTROL NUMBER: 27-AS-20231121101050

FACILITY NAME:	LEGACY OAKS OF SACRAMENTO		FACILITY NUMBER:	342701122
ADMINISTRATOR:	MELISSA ORELLO		FACILITY TYPE:	740
ADDRESS:	1922 MORSE AVENUE		TELEPHONE:	(916) 482-7745
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95825
CAPACITY:	160	CENSUS: 103	DATE:	12/12/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Alicia Duchines		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Staff did not provide resident's authorized representative with resident's records in a timely manner.

INVESTIGATION FINDINGS:

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On 12/12/23, Licensing Program Analyst (LPA) Kimberly Viarella made an unannounced visit to this facility to deliver the findings of this complaint investigation. The LPA identified herself upon arrival and asked to meet with the Designated Facility Administrator (DFA). LPA met with the current DFA, Alicia Duchines. A brief interview followed.

LPA conducted a walkthrough of the facility. LPA observed multi-cultural holiday decorations in the lobby. In the activities room, LPA witnessed 5 residents and 2 staff making clay jewelry and other crafts with a 3rd staff member preparing for another activity. Further down the hall, LPA passed a medication cart and tested the drawer to ensure it was locked, as required. The cart was locked and secured. At this time, Assisted Living common areas/hallways were free of odors. LPA entered Memory Care. There was a strong smell of bleach. LPA observed a caregiver painting the nails of a resident, while other residents were seated in a conversation area nearby and listening to music. LPA brought the strong smell of bleach to the caregiver's

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Kimberly Viarella	TELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023

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-20231121101050

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: LEGACY OAKS OF SACRAMENTO	FACILITY NUMBER: 342701122
	VISIT DATE: 12/12/2023

NARRATIVE

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attention and she informed the LPA that a resident had just had an accident in the hallway and staff had just cleaned and disinfected the area. LPA found another caregiver to assist with ventilating the space. After completing the walkthrough, this LPA returned to her workstation.

Regarding the allegation: "Staff did not provide resident's authorized representative with resident's records in a timely manner." During the course of this investigation, this LPA learned that most bills were sent out electronically via email on either the 23rd or 24th of the month. LPA was also told that if a resident or POA preferred to have a paper bill mailed instead, they would do that. This LPA learned through interviews that many residents secured their rooms with the Assisted Living Waiver Program (ALWP). They had a care coordinator who assisted them with the transition and the cost was assessed based on the resident's income. Room and board were established at a set price that was direct billed to that program on a month to month basis.

This LPA further learned that if a resident were self-pay, a clinical assessment would have been completed by members of the administrative team to determine the level of care needed and a monthly fee would have been established. Fees were billed between the 1st and the 7th of each month for all but one resident. (One resident requested a different billing date, and that was honored.) Staff also shared that if there was a change in condition for a self-paying resident, a new assessment would have been done and a new fee would have been assessed. The Financial Power of Attorney would have been informed of the new bill rate by the Administration. This LPA asked what the turnaround time was if a resident requested a copy of their bill be emailed to them. This LPA was told that usually a request like that could be taken care of the same day, but it might take up to 24 hours if the Business Office was exceptionally busy.

This LPA called the number provided by the complainant for additional details to assist in this investigation, and no further information could be obtained. The standard for the preponderance of the evidence was not met and the Department finds this allegation to be UNSUBSTANTIATED. A finding of Unsubstantiated means that although the allegation(s) may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation(s) occurred.

Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 6, no deficiencies were cited.
A copy of this report was provided, along with Appeal Rights and the LIC 811, the Confidential Names List.
Exit interview.

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Kimberly Viarella	TELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023

LIC9099 (FAS) - (06/04)

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