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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347001498
Report Date: 04/09/2024
Date Signed: 04/09/2024 03:24:42 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
01/30/2024 and conducted by Evaluator Sabrina Calzada
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20240130093332
FACILITY NAME:CITRUS HEIGHTS TERRACEFACILITY NUMBER:
347001498
ADMINISTRATOR:TONI JONESFACILITY TYPE:
740
ADDRESS:7952 OLD AUBURN ROADTELEPHONE:
(916) 727-4400
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:45CENSUS: 42DATE:
04/09/2024
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Editha McCullough, Administrator DesigneeTIME COMPLETED:
12:55 PM
ALLEGATION(S):
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Staff are denying resident visitations.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conclude a complaint investigation for a complaint received on 1/30/24. LPA met with Editha McCullough, Administrator Designee, and explained the reason for the inspection.

During the course of the investigation, LPA interviewed the Administrator, Resident Care Coordinator, a Med-Tech staff, (R1') resident's family member. LPA attempted to interview resident (R1) but was unable to obtain useful information due to resident's diagnosis of Dementia. LPA reviewed documentation related to R1's family member being given restricted in-person visitation hours, including (2) letters sent to the family member in Decemer 2023 and January 2024.

The results of the investigation are as follows:

**cont on 9099C-1...
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina CalzadaTELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
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 3
Control Number 59-AS-20240130093332
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: CITRUS HEIGHTS TERRACE
FACILITY NUMBER: 347001498
VISIT DATE: 04/09/2024
NARRATIVE
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9099C-1... Allegation: Staff are denying resident visitations. The complaint states that on 1/30/24, resident's family member called the facility to check on resident (R1) and was told she was feeling agitated so was given a Trazadone. Resident's family member requested to visit (R1) later that day, after 5:00 pm, and was told she could not due to the recently imposed restricted visitation hours on the family member.

Additional information was received by the Department on 1/31/24 stating resident's family member had received a letter from the facility, on 1/3/24, and then a subsequent letter about violating the agreement made regarding issues addressed at the meeting in December 2023. Family member stated there are no violations and the facility's actions are retaliatory.

On 2/5/24, additional information was received that resident's family member returned (R1) to the facility on 2/2/24, around 6:00 pm, after taking resident out for the afternoon, and the facility Administrator, who was present at that time, would not allow her to stay/say good-bye to resident since it was after 5:00 pm.

LPA reviewed a letter that was given to resident's family member on 12/28/23, as a follow up to the meeting held on 12/15/23 to discuss concerns raised by resident's family member. The letter lists concerns the facility has had with resident's family member engaging in inappropriate communications with staff members and states the communication arrangements requested by the facility to mitigate these concerns. The letter cites (4) additional concerns/incidents that have occurred regarding communication between staff and resident's family member since the meeting on 12/15/23. The letter then lists additional measures the facility will begin to implement to "keep appropriate communication lines open for (R1's) care and balance that with the rights of other residents and employees at the community", including requesting (R1's) family member communicate directly with facility management, and to not contact care staff directly on their cell phones.

LPA reviewed an email received from the Administrator on 1/2/24 that was also sent to same individuals who attended the meeting on 12/15/23. The email expressed how several staff recently stated they are becoming increasingly uncomfortable with resident's family member due to their communications and interactions with her. LPA was provided with copies of statements made by staff confirming this information.

A second letter was sent to resident's family member on 1/17/24, noting it is a follow up to the conversation the Administrator had with this family member on 1/11/24. The letter states there are (4) specific parameters being implemented regarding future visitation at the community with the first restriction stating in-person visitation will only be permitted between 9:00 am - 5:00 pm, daily.
**cont on 9099C-2..
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina CalzadaTELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 59-AS-20240130093332
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: CITRUS HEIGHTS TERRACE
FACILITY NUMBER: 347001498
VISIT DATE: 04/09/2024
NARRATIVE
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9099C-2... It was later clarified that resident's family member can communicate by phone with (R1) until 9:00 pm, but the in-person visitation would remain restricted to the hours of 9:00 am - 5:00 pm.

Both the Administrator and RCC confirmed on 1/30/24 that (R1's) family member was recently given restricted in-person visitation rights from 9:00 am - 5:00 pm. The RCC stated that resident's family member did contact her by phone on/around 1/30/24 in the late afternoon, asking if she could visit her mom in the evening, but the request was denied by the Administrator, as resident was previously informed of the restrictions in place.

A citation was issued on 1/25/24 for the facility not allowing resident's family member to talk with resident by phone, on 1/20/24, between the regular visiting hours of 9:00 am- 9:00 pm.

Based on information obtained, LPA finds the allegation to be UNFOUNDED-meaning that the allegation was false, could not have happened and/or is without reasonable basis.

Exit interview. Copy of report provided to the facility.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina CalzadaTELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3