342701159-1-12-2023-27-AS-KHOS-CNFRSG-20230126121640

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342701159
Report Date: 01/03/2023
Date Signed: 01/12/2023 10:52:52 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
11/22/2022 and conducted by Evaluator Kesha Lewis

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20221122143911

FACILITY NAME:	BEATRICE SENIOR CARE		FACILITY NUMBER:	342701159
ADMINISTRATOR:	MITITI, BIANCA		FACILITY TYPE:	740
ADDRESS:	8901 MELODIC CT		TELEPHONE:	(916) 270-3961
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	6	CENSUS: 5	DATE:	01/03/2023
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Beatrice Clark		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff threatened to illegally evict resident

INVESTIGATION FINDINGS:

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LPA Kesha Lewis conducted a complaint visit to this facility today to conclude a complaint for the allegations listed above. LPA met with Staff and Licensee and explained the purpose for todays.
Allegation: Staff threatened to illegally evict resident: LPA interviewed licensee and Reporting party. Per licensee, this facility has not issued an eviction notice in the past year. The Licensee never gave a verbal and written notification. The resident is still residing at the facility. Based on LPAs interviews and review of documentation, the preponderance of evidence standards has not been met, therefore, the above allegation(s) is found to be UNSUBSTANTIATED.

The investigation is concluded, based on interviews and file reviews that the allegations were unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violations occurred

Based on LPA’s observations and interviews conducted, the preponderance of evidence standard has not been met, therefore the above allegations are determined to be UNSUBSTANTIATED.
Per California Code of Regulations, Title 22 Division 6, Chapter 8, no deficiencies are being cited. Exit interview held, a copy of report given during today’s visit.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Liza King	TELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Kesha Lewis	TELEPHONE: (650) 676-0552
LICENSING EVALUATOR SIGNATURE:	DATE: 01/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2023

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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