347000931-7-27-2023-59-AS-APEZ-CU72SH-20230728173909

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347000931
Report Date: 07/27/2023
Date Signed: 07/27/2023 02:36:47 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
03/28/2023 and conducted by Evaluator Sarena Keosavang

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20230328161840

FACILITY NAME:	CANDLELIGHT HOME CARE		FACILITY NUMBER:	347000931
ADMINISTRATOR:	DOBRE, EMIL		FACILITY TYPE:	740
ADDRESS:	7224 CANDLELIGHT WAY		TELEPHONE:	(916) 725-5680
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95621
CAPACITY:	6	CENSUS: 4	DATE:	07/27/2023
		UNANNOUNCED	TIME BEGAN:	01:57 PM
MET WITH:	Administrator: Emil Dobre		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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- Residents are chemically restrained with medication.
- Facility staff not fingerprint-cleared.
- Staff are using drugs while on duty.
- Facility staff are abusing residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility unannounced on 07/27/2023 to deliver complaint findings Community Care Licensing (CCL) received on 03/28/2023. LPA met with Administrator, Emil Dobre, and explained the purpose of the visit.

During the course of the investigation, the Department interviewed facility staff, residents in care, and obtained pertinent documents relevant to the complaint investigation such as, four (4) residents’ (R1, R2, R3, & R4,) physician’s report, identification and emergency information, medication list, physician’s orders, medication administration records (MAR), employee roster, resident roster, and staff trainings.

Continue on page LIC 9099-C.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Sarena Keosavang	TELEPHONE: (209) 202-9552
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023

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-20230328161840

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: CANDLELIGHT HOME CARE	FACILITY NUMBER: 347000931
	VISIT DATE: 07/27/2023

NARRATIVE

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Allegation: Residents are chemically restrained with medication. Unfounded.
Administrator submitted staff training records to CCL for review. Administrator completed PRN medications training on 02/20/2023. Administrator completed medication training on 01/28/2023 and medication marijuana and psychoactive medication on 01/27/2023. LPA reviewed 4 of 4 resident medications, comparing with physician orders, medication administration records, and found no discrepancies. Administrator stated staff do not provide medications to residents that are not prescribed by their physicians. LPA interviewed a total of 2 residents. R1 & R2 indicated staff assists residents with their medication and denies staff chemically restraining residents with medication.

Allegation: Facility staff not fingerprint-cleared. Unfounded.
LPA reviewed staff files, training, and reviewed facility association list. LPA observed that all staff are associated to the facility roster and have valid ID's.

Allegation: Staff are using drugs while on duty Unfounded.
On 04/04/2023, LPA toured the facility and did not observe any illegal drugs or evidence of drug use. Administrator stated there is only one staff working at the facility along side administrator. Administrator and staff (S1) stated they have not observed any staff using drugs while on duty. LPA interviewed a total of 2 residents. R1 and R2 stated they have not observed staff using drugs while providing care to residents.

Allegation: Facility staff are abusing residents. Unfounded.
LPA interviewed administrator and S1 in which they stated they have not abused residents in anyway and they have not observed any other staff member abuse residents. LPA interviewed 2 resident. R1 and R2 stated they have not observed any residents in care being abused by staff.

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

Exit interview conducted.

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Sarena Keosavang	TELEPHONE: (209) 202-9552
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023

LIC9099 (FAS) - (06/04)

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