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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701212
Report Date: 10/19/2022
Date Signed: 10/19/2022 11:00:33 AM

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
10/14/2022 and conducted by Evaluator Christopher Hopkins-Clarke
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20221014160918
FACILITY NAME:CARLTON SENIOR LIVING SACRAMENTO ATRIUMFACILITY NUMBER:
342701212
ADMINISTRATOR:KASIE WIMMERFACILITY TYPE:
740
ADDRESS:1071 FULTON AVENUETELEPHONE:
(916) 971-4800
CITY:SACRAMENTOSTATE: CAZIP CODE:
95825
CAPACITY:99CENSUS: 55DATE:
10/19/2022
UNANNOUNCEDTIME BEGAN:
09:07 AM
MET WITH:Kasie WimmerTIME COMPLETED:
11:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
-Resident not being provided supplies in a timely manner
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/19/22 at 9:07AM, Licensing Program Analyst (LPA) Chris Hopkins conducted an unannounced facility visit in regards to a complaint investigation with the above allegations. LPA met with Administrator Kasie Wimmer and stated the purpose of this visit.

Regarding the allegation of Resident not being provided supplies in a timely manner, the Department found the following; based on interview and observation, it was determined that Resident 1 (R1) has the necessary supply to meet incontinence needs. R1 is worried about running out, when the supply gets low. LPA suggested the facility order more, so he/she always has an ample amount. R1 informed LPA that he/she is willing to pay for the increased amount of supplies.

LPA has deemed the complaint findings as UNSUBSTANTIATED. Although the allegation may have happened and/or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.
Exit interview conducted. A copy of this report was left with staff upon exit.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Czarrina A Camilon-LeeTELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Christopher Hopkins-ClarkeTELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
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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