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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701248
Report Date: 07/19/2024
Date Signed: 07/19/2024 03:31:47 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
05/08/2024 and conducted by Evaluator Michael Bilger
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20240508134903
FACILITY NAME:SACRAMENTO SENIOR LIVING IIFACILITY NUMBER:
342701248
ADMINISTRATOR:LEWIS, SALOTEFACILITY TYPE:
740
ADDRESS:34 LOMA MAR CTTELEPHONE:
(530) 710-5707
CITY:SACRAMENTOSTATE: CAZIP CODE:
95828
CAPACITY:6CENSUS: 4DATE:
07/19/2024
UNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Melvin HindsTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff did not prevent residents from having access to illegal drugs
Staff inappropriately touched resident
INVESTIGATION FINDINGS:
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On 7-19-24 at 1:05pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver findings for the allegations noted above. LPA met with lead caregiver and explained the purpose of the visit. Administrator Salote Lewis was contacted by LPA via phone and gave permission for lead caregiver to sign in her absence. During this investigation, the Department conducted interviews with three staff members and three residents in care.

Allegation: Staff did not prevent residents from having access to illegal drugs. Based on interviews conducted, it was revealed R1 was witnessed by a staff member to have returned to the facility “high” after leaving facility with R1’s family member for an outing, however, was not revealed by staff that R1used drugs in the facility. Additionally, it was revealed that no corroborated statements existed to suggest illegal drug use within the facility by any residents.
{Cont. on 9099C}
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Liza KingTELEPHONE: (650) 676-0442
LICENSING EVALUATOR NAME: Michael BilgerTELEPHONE: (916) 862-4722
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2024
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 3
Control Number 27-AS-20240508134903
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: SACRAMENTO SENIOR LIVING II
FACILITY NUMBER: 342701248
VISIT DATE: 07/19/2024
NARRATIVE
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This includes witnessing residents using illegal drugs or the observation of illegal drugs within the facility. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. A finding of unsubstantiated means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

Allegation: Staff inappropriately touched resident. This allegation was investigated by the department and consisted of interviews as stated above. This allegation included an accusation of molestation by staff. Based on interviews conducted, it was determined that R1 required assistance with bathing and preferred not to have “his private parts” washed. It was further revealed through interview that on one occasion, staff2 (S2) was assisting R1 with bathing and proceeded to mistakenly wash R1’s private area in the shower and stopped once told by R1 to do so. Additional interviews revealed no corroborated statements of being touched inappropriately by S2. Based on evidenced obtained, there is no preponderance of evidence to show that S2 inappropriately touched R1 with the intent to sexually gratify either party involved, therefore, this allegation is UNSUBSTANTIATED. A finding of unsubstantiated means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with lead caregiver and a copy of this report was provided. Appeal rights provided.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (650) 676-0442
LICENSING EVALUATOR NAME: Michael BilgerTELEPHONE: (916) 862-4722
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2024
LIC9099 (FAS) - (06/04)
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