347001241-7-17-2024-27-AS-KHOS-D83Q77-20240812115440

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347001241
Report Date: 07/17/2024
Date Signed: 07/17/2024 11:46:31 AM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
03/20/2024 and conducted by Evaluator Kimberly Viarella

COMPLAINT CONTROL NUMBER: 27-AS-20240320134223

FACILITY NAME:	ESKATON GOLD RIVER LODGE		FACILITY NUMBER:	347001241
ADMINISTRATOR:	NEAL TORRES		FACILITY TYPE:	740
ADDRESS:	11390 COLOMA RD		TELEPHONE:	(916) 852-7900
CITY:	GOLD RIVER	STATE: CA	ZIP CODE:	95670
CAPACITY:	134	CENSUS: 84	DATE:	07/17/2024
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Neal Torres		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff are not providing adequate food service to residents.

INVESTIGATION FINDINGS:

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On 07/17/24, Licensing Program Analyst (LPA) Kimberly Viarella made an unannounced visit to this facility to deliver the findings to this investigation. LPA identified herself upon arrival, stated the purpose of the visit and asked to meet with the Designated Facility Administrator (DFA). LPA met with DFA / Executive Director Neal Torres and a brief interview followed.

LPA and DFA conducted a walkthrough of the facility with particular time and attention spent on the kitchen. LPA observed 7 staff in the kitchen. LPA did not observe anyone with long, loose, unsecured hair. The kitchen was clean, organized, condiment station was clean, all lids were secured, individual bulk items like packaged cookies were in dated bins. There had been a new delivery of frozen foods and items were boxed and shelved accordingly. LPA observed 4 residents in the dining room finishing up breakfast and 2 servers on hand to assist them.

With regard to the allegation, "Staff are not providing adequate food service to the residents." The reporting

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Kimberly Viarella	TELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024

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 27-AS-20240320134223

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ESKATON GOLD RIVER LODGE	FACILITY NUMBER: 347001241
	VISIT DATE: 07/17/2024

NARRATIVE

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party stated that food was being served at improper temperatures. Through interviews and observation, this LPA learned that there was a fan located above the kitchen hood where food would be placed for staff to carry out to the residents. This fan kept the kitchen and the staff form getting too warm, but it would also cool the food down quickly. This was one reason why residents were receiving food that was not at its proper serving temperature. This LPA also learned that some of the staff at the time did not know how to pace the meals. The staff might bring out the soup, salad, and entree at the same time. By the time the resident finished their first course, the entree would be cold. In addition to these reasons, this LPA also learned that there had been issues with kitchen equipment during the time frame of this complaint. The top oven broke and therefore staff had to cook in batches and use a hot box to keep meals warm. At one point, the hot box broke too.

Since the time of the complaint, the facility has had the oven repaired and purchased a new hot box. The Kitchen Manager has implemented a new role, Culinary Lead, to assist with training staff. Food is not put up under the hood for delivery until just before it is to be delivered and the staff has been trained to pace the delivery of each course.

The standard for the preponderance of evidence has been met and the department finds this allegation to be SUBSTANTIATED. According to the California Code of Regulations, Title 22, the citation may be found on the LIC 9099 D page.

A copy of this report was provided, along with APPEAL RIGHTS.

Exit interview.

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Kimberly Viarella	TELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024

LIC9099 (FAS) - (06/04)

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Control Number 27-AS-20240320134223

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ESKATON GOLD RIVER LODGE	FACILITY NUMBER: 347001241
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/17/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/17/2024 Section Cited CCR 97555(b)(9)	1 2 3 4 5 6 7	General Food Service-The following food service requirements shall apply: (9) Procedures which protect the safety, acceptability and nutritive values of food shall be observed in food storage, preparation and service. This was not met as evidenced by:	1 2 3 4 5 6 7	The facility has repaired or replaced the faulty equipment, trained kitchen staff not to place food under the hood until it is time to be delivered, and trained server to pace meals. This plan of correction has already been met. This POC has been cleared.
	8 9 10 11 12 13 14	Based on interviews, food was not being served at the appropriate temperature due to equipment malfunction, the placement of a fan over the hood in the kitchen, and staff not being trained to pace meals. This posed a potential threat to the health, safety and/or personal rights to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Kimberly Viarella	TELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
03/20/2024 and conducted by Evaluator Kimberly Viarella

COMPLAINT CONTROL NUMBER: 27-AS-20240320134223

FACILITY NAME:	ESKATON GOLD RIVER LODGE		FACILITY NUMBER:	347001241
ADMINISTRATOR:	NEAL TORRES		FACILITY TYPE:	740
ADDRESS:	11390 COLOMA RD		TELEPHONE:	(916) 852-7900
CITY:	GOLD RIVER	STATE: CA	ZIP CODE:	95670
CAPACITY:	134	CENSUS: 84	DATE:	07/17/2024
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Neal Torres		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff did not ensure the kitchen was clean.
Staff did not ensure the facility floors were clean.

INVESTIGATION FINDINGS:

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On 07/17/24, Licensing Program Analyst (LPA) Kimberly Viarella made an unannounced visit to this facility to deliver the findings for thiscomplaint investigation. LPA identified herself upon arrival, stated the purpose of the visit and asked to meet with the Designated Facility Administrator (DFA). LPA met with DFA / Executive Director Neal Torres and a brief interview followed.

LPA and DFA conducted a walkthrough of the facility with particular time and attention spent on the kitchen. LPA observed 7 staff in the kitchen. LPA did not observe anyone with long, loose, unsecured hair. The kitchen was clean, organized, condiment station was clean, all lids were secured, individual bulk items like packaged cookies were in dated bins, there had been a new delivery of frozen foods and items were boxed and shelved accordingly. LPA observed 4 residents in the dining room finishing up breakfast and 2 servers on hand to assist them.

With regard to the allegations that, "Staff did not ensure the kitchen was clean," and "Staff did not ensure

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Kimberly Viarella	TELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 27-AS-20240320134223

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ESKATON GOLD RIVER LODGE	FACILITY NUMBER: 347001241
	VISIT DATE: 07/17/2024

NARRATIVE

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the facility floors were clean," this LPA has toured this facility 6 times. This LPA has completed a walkthrough of the facility on the following dates: 03/29/24, 06/10/24, 06/11/24, 06/24/24, 07/10/24, and 07/17/24. The LPA did not observe the kitchen or facility floors to be unclean.

The standard for the preponderance of evidence has not been met and the department finds these two allegations to be UNSUBSTANTIATED. A finding of unsubstantiated means that although the allegation(s) may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation(s) occurred.

According to the California Code of Regulations, Title 22, this LPA did not observe or cite any deficiencies during today's visit. A copy of this report was provided along with APPEAL RIGHTS.

Exit Interview.

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Kimberly Viarella	TELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024

LIC9099 (FAS) - (06/04)

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