345002854-6-12-2025-59-AS-LMUZ-DJCM3T-20250707091536

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 345002854
Report Date: 06/12/2025
Date Signed: 06/12/2025 12:01:56 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
05/02/2025 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 59-AS-20250502153659

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: 57	DATE:	06/12/2025
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Administrator, Darrell Price		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff did not provide adequate supervision resulting in resident elopement.
Facility staff did not provide adequate bathing service to resident care.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 06/12/25, Licensing Program Analyst (LPA) Talwinder Bains arrived unannounced to deliver complaint findings for allegations listed above. LPA met with Administrator, Darrell Price during today's visit and explained the purpose of the visit.

The department conducted records review and interviews with staff and residents to investigate the complaint.

**Report continued on LIC9099-C**

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2025

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 2

Control Number 59-AS-20250502153659

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: 06/12/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

***Report continued from 9099....

Allegation- Facility staff did not provide adequate supervision resulting in resident elopement.

Department conducted records review and staff’s interviews to investigate this allegation. Record review indicated that per LIC602 (dated-03/28/25) for resident, R1 indicated that R1 was able to leave the facility unassisted without staff’s assistance or supervision. Additionally, R1s needs and service plan did not indicate that R1 was AWOL/Elopement risks when R1 moved into the facility on 04/01/25. Three staff interviews reflected that staff were not aware that R1 was AWOL/Elopement risk but were aware that R1 can leave facility unassisted. Staff interviews reflected that on 04/27/25 around 1pm, R1 exited from facility and went to main street with suicidal thoughts but staff immediately provided necessary help to R1 and brought back R1 to facility with presence of law enforcement. Facility sent out R1 to hospital on 04/27/25 to seek the appropriate medical care for R1 to ensure their health and safety. From gathered information, it has been concluded that even R1 eloped from facility on 04/27/25, it was not due to staff’s lack and supervision, so this allegation was found to be UNSUBSTANTIATED.

Allegation- Facility staff did not provide adequate bathing service to resident care.

Department conducted records review and staff’s interviews to investigate this allegation. Record review indicated that per LIC602 (dated-03/28/25) for resident, R1 indicated that R1 was able to take their shower Independently and stand by assistance needed by staff. During staff’s interviews, staff, S3 who were main morning caregiver during R1s facility stay from 04/01/25 till incident date (04/27/25), indicated that they assisted with R1s showers 5-6 times and R1 expressed no concerns. Record review and interviews did not indicate any concerns regarding R1s bathing services at facility, so this allegation was found to be UNSUBSTANTIATED.

A finding that the complaint allegations 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 .A copy of this report has been provided to facility.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 2