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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 345002831
Report Date: 11/16/2023
Date Signed: 11/16/2023 11:08:49 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH 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
09/07/2023 and conducted by Evaluator Talwinder Bains
COMPLAINT CONTROL NUMBER: 59-AS-20230907093643
FACILITY NAME:PEOPLE'S CARE KRANS COURTFACILITY NUMBER:
345002831
ADMINISTRATOR:BRITT, AMANDAFACILITY TYPE:
735
ADDRESS:8530 KRANS COURTTELEPHONE:
(909) 287-3557
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY:4CENSUS: 3DATE:
11/16/2023
UNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Administrator, Diamond Anderson TIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff do not prevent residents from engaging in inappropriate behaviors.
Staff mismanaged residents’ medication.
INVESTIGATION FINDINGS:
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On 11/16/23, Licensing Program Analyst (LPA) Talwinder Bains arrived unannounced to deliver the complaint findings. LPA met with Administrator, Diamond Anderson and explained the purpose of today's visit.

Throughout the course of the investigation the department reviewed documentation ,facility observations and conducted interviews relevant to the complaint allegations.



Report continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023
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 4
Control Number 59-AS-20230907093643
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: PEOPLE'S CARE KRANS COURT
FACILITY NUMBER: 345002831
VISIT DATE: 11/16/2023
NARRATIVE
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**report continued from 9099.......

Allegation- Staff do not prevent residents from engaging in inappropriate behaviors.

The department conducted interviews with residents and staff, facility’s observations, and record review to investigate this allegation. Allegations in this complaint indicated that R2 engages in inappropriate behaviors with R1. From staff and residents’ interview, it has been revealed that resident R2 will sometimes go into R1’s bedroom and hide under the bed. Interviews indicated R2 has 24 hour 1:1 staff and therefore staff is always with R2. Interviews with staff stated that staff have never witnessed any of the residents in this home engaging in inappropriate behavior with each other. Based on the allegation that residents engage in inappropriate behavior, this allegation is found to be Unsubstantiated.

Allegation- Staff mismanaged residents’ medication.

Based on the department's investigation, including facility observations, record review, and interviews with staff and residents, it has been concluded that the allegation made against the facility regarding medication administration is unsubstantiated. The interviews with both staff and residents indicated that medications were being given to all residents as prescribed. The facility maintained proper logs and documentation for all medications according to physician's orders. The residents confirmed that they were receiving their scheduled medications and the staff were not mismanaging their medications, therefore, the allegation is determined to be without basis or evidence and is therefore considered Unsubstantiated.

A finding of Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted.


SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4