345002881-5-2-2024-59-AS-MSEY-D52KWZ-20240507081643

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 345002881
Report Date: 05/02/2024
Date Signed: 05/02/2024 12:01:22 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
04/25/2024 and conducted by Evaluator Kevin Mknelly

COMPLAINT CONTROL NUMBER: 59-AS-20240425155119

FACILITY NAME:	CARE HORIZONS ASSISTED LIVING, LLC		FACILITY NUMBER:	345002881
ADMINISTRATOR:	IORDACHE-STIR, ADRIANA		FACILITY TYPE:	740
ADDRESS:	6630 CARE LANE		TELEPHONE:	(916) 205-2273
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	6	CENSUS: 5	DATE:	05/02/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Adriana Stir		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Personal rights violations
Staff denied residents' food.
Staff did not ensure that a resident's hygiene needs were being met.

INVESTIGATION FINDINGS:

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On 5/1/24 , Licensing Program Analyst (LPA) Kevin Mknelly LPA Mknelly arrived and met with caregivers. The Administrator arrived for LPA to investigate and deliver investigation findings.
LPA reviewed facility records, and conducted and extensive interview with R1.
LPA finds that facility met Tittle 22 requirements.
LPA reviewed R1's LIC 602 and interviewed R1 10-11 AM, privately in R1's room.
LPA and R1 discussed a number of R1's medical conditions and things that R1 wishes to resolve.
R1 was questioned about the allegations and stated that his care is good but he would like to receive additional therapy for what he perceives are issues effecting his mobility and independence. R1 demonstrated a lack of insight to his current diagnosis and abilities. R1 stated they are happy with the care they recieve in this home.
This agency has investigated the above complaint allegations. We have found that the complaint is UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.
Exit interview conducted and report provided.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin Mknelly	TELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:	DATE: 05/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024

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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