345002854-3-27-2024-59-AS-KHOS-D3XLR3-20240402085829

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 345002854
Report Date: 03/27/2024
Date Signed: 03/27/2024 12:35:29 PM

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
02/09/2024 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 59-AS-20240209143516

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: 60	DATE:	03/27/2024
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Assistant Director, Tosha Devi		TIME COMPLETED:	12:40 PM

ALLEGATION(S):

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Staff do not administer resident's medications as prescribed.
Staff do not assist resident with ADLs.
Staff do not assist resident with ambulating.

INVESTIGATION FINDINGS:

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On 03/27/24, Licensing Program Analysts (LPAs) Talwinder Bains and Cheyenne Ratajczak arrived unannounced to deliver complaint findings for allegations listed above. LPAs 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**

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: 03/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

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-20240209143516

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: 03/27/2024

NARRATIVE

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***Report continued from 9099.......
Allegation- Staff do not administer resident's medications as prescribed.

Based on the information provided, the investigation conducted by the department involved facility observations, record review, and interviews with staff (4) and residents (4) to investigate the complaint allegation. During these interviews, it was revealed that the facility dispensed 4 residents' medications on time and administered them as scheduled. 3 out of 4 residents’ interviews indicated that staff were assisting them with their medications without any issues. Furthermore, a review of the records for resident, R1 the months of January and February 2024, indicated that the facility maintained a proper logs for all medications in the centrally stored medication log, following physician's orders, and documenting them in the Medication Administration Record (MAR) without any errors. Based on these findings, this allegation is considered UNSUBSTANTIATED.

Allegation- Staff do not assist resident with ADLs.

The department conducted staff and residents' interviews, reviewed records to investigate the allegation. During residents’ (4) interviews, 3 out of 4 residents stated that staff respond to residents needs in a timely manner, however sometimes there is a delay in response due to staff assisting other residents’ needs. Interviews and record reviews for 4 residents indicated that resident’s ADL’s which includes residents showering, incontinence and care needs are met as required and documented accordingly. 3 out of 4 residents’ interviews indicated that staff were providing care in a professional manner and did not express any concerns. Furthermore, LPA observed facility found to be clean and odor free during department visits and residents interviews indicated no issues with care, therefore this allegation is found to be UNSUBSTANTIATED.

Allegation- Staff do not assist resident with ambulating.

The department conducted staff (4) and residents' (4) interviews, reviewed records to investigate the allegation. Record review indicated that facility was assisting residents with their activities of daily living per residents needs and service planning including assisting with ambulation and documenting accordingly. 3 out of 4 residents interviewed reflected that staff were assisting with their ADL care needs and did not express any concerns. Staff interviews (4) indicated that staff were helping residents with their care needs and there were no issues. Based on this information,this allegation is found to be UNSUBSTANTIATED.

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

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Talwinder Bains	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

LIC9099 (FAS) - (06/04)

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