345002854-7-18-2024-59-AS-LMUZ-D7J2YH-20240725174844

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 345002854
Report Date: 07/18/2024
Date Signed: 07/18/2024 02:57:57 PM

Unfounded

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
02/28/2024 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 59-AS-20240228115229

FACILITY NAME:	ALMOND GROVE ASSISTED LIVING		FACILITY NUMBER:	345002854
ADMINISTRATOR:	PRICE, DARRELL		FACILITY TYPE:	740
ADDRESS:	6135 ALMOND AVENUE		TELEPHONE:	(916) 988-7506
CITY:	ORANGEVALE	STATE: CA	ZIP CODE:	95662
CAPACITY:	78	CENSUS: 58	DATE:	07/18/2024
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Assistant Director, Tosha Devi		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Facility staff did not seek medical attention for resident in a timely manner.
Staff did not notify resident’s representative of incidents.

INVESTIGATION FINDINGS:

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On 07/18/24, Licensing Program Analyst (LPA) Talwinder Bains arrived unannounced to deliver complaint findings for allegations listed above. LPA met with Assistant Director, Tosha Devi during today's visit and explained the purpose of the visit. .

The department conducted records review ,facility observations and interviews to investigate the complaint.

**Report continued on LIC9099-C**

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Talwinder Bains	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2024

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 59-AS-20240228115229

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: ALMOND GROVE ASSISTED LIVING	FACILITY NUMBER: 345002854
	VISIT DATE: 07/18/2024

NARRATIVE

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**Report continued from 9099...

Allegation- Facility staff did not seek medical attention for resident in a timely manner.-Unfounded

The Department conducted interviews with Administrator, three (3) staff, and reviewed records to investigate this allegation. Administrator and three staff interviews indicated that facility noticed change in condition for resident, R1 around 01/23/24 and send them out to local hospital to sought medical care. Record review indicated that facility kept proper documentation regarding R1s health status and reported to R1s responsible party, physician and CCLD per requirements. Based on this information, this allegation is Unfounded.

Allegation- Staff did not notify resident’s representative of incidents.-Unfounded

The Department conducted interviews with Administrator, three (3) staff, and reviewed records to investigate this allegation. Administrator and three staff interviews indicated that facility was notifying R1s responsible party for any change of condition and to update any health changes related to R1 without any issues. Record review reflected that facility kept proper call logs, email communications and other modes of communications by which facility was notifying R1s responsible party to notify R1s health related incidents per regulations and there were no concerns. Based on this information, this allegation is Unfounded.

A finding that the allegations are unfounded means that the allegations are false, could not have happened, and/or is without a reasonable basis.

Exit interview conducted. A copy of this report has been provided to facility.

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Talwinder Bains	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2024

LIC9099 (FAS) - (06/04)

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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
02/28/2024 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 59-AS-20240228115229

FACILITY NAME:	ALMOND GROVE ASSISTED LIVING		FACILITY NUMBER:	345002854
ADMINISTRATOR:	PRICE, DARRELL		FACILITY TYPE:	740
ADDRESS:	6135 ALMOND AVENUE		TELEPHONE:	(916) 988-7506
CITY:	ORANGEVALE	STATE: CA	ZIP CODE:	95662
CAPACITY:	78	CENSUS: 58	DATE:	07/18/2024
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Assistant Director, Tosha Devi		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Staff left resident in soiled diapers for an extended period of time.

INVESTIGATION FINDINGS:

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On 07/18/24, Licensing Program Analyst (LPA) Talwinder Bains arrived unannounced to deliver complaint findings for allegation listed above. LPA met with Assistant Director, Tosha Devi during today's visit and explained the purpose of the visit.

Allegation- Staff left resident in soiled diapers for an extended period of time. Unsubstantiated.

Department conducted interviews with Administrator, three (3) staff, and two (2) residents to investigate this allegation. During the interview process it was reported that staff supervise residents twenty-four (24) hours a day and check on residents every two hours to provide residents toilet care needs. It was reported that staff are conscience of keeping the residents clean and dry. Resident’s interviews reflected that staff were providing care per their needs and service plan and there were no issues. LPA toured the facility and facility observed to be clean sanitary and free from odors. LPA did not observe any dirty diapers or smell of urine/feces. Based on this information, this allegation is Unsubstantiated.A finding that the complaint allegation is UNSUBSTANTIATED means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

Exit meeting conducted and copy of this report has been provided to facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Talwinder Bains	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2024

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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