347002045-1-11-2023-25-AS-MSEY-CN2LUU-20230113080429

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347002045
Report Date: 01/11/2023
Date Signed: 01/11/2023 04:15:52 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/01/2022 and conducted by Evaluator Sabrina Calzada

PUBLIC

COMPLAINT CONTROL NUMBER: 25-AS-20221201084111

FACILITY NAME:	COUNTRY OAKS MANOR		FACILITY NUMBER:	347002045
ADMINISTRATOR:	ALEKSANDER MOLITVENIK		FACILITY TYPE:	740
ADDRESS:	7595 LINDEN AVENUE		TELEPHONE:	(916) 792-4974
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY:	6	CENSUS: 5	DATE:	01/11/2023
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Alex Molitvenik, Administrator		TIME COMPLETED:	04:20 PM

ALLEGATION(S):

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Facility staff is under the influence while providing care and supervision to residents.
Facility smells of marijuana.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conclude and deliver investigative findings to a complaint received on 12/1/2022 . LPA met with Administrator, Alex Molitvenik, and explained purpose of inspection. Administrator advised LPA that staff (S1) was off work today. LPA completed required COVID-19 protocols and was screened per Covid-19 precautionary measures upon entering the facility, and LPA was wearing a surgical mask. LPA observed (2) residents to be in the common areas and (3) residents to be in their rooms at the start of the inspection.

During the investigation, LPA interviewed the Administrator, (2) residents, staff (S1), a family member of one of the resident (R3), and a neighbor. LPA also observed the facility by touring on 12/9/22 and on 1/11/23.

The results of the investigation are as follows:

cont on 9099C-1..

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina Calzada	TELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

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 25-AS-20221201084111

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: COUNTRY OAKS MANOR	FACILITY NUMBER: 347002045
	VISIT DATE: 01/11/2023

NARRATIVE

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Allegation: Facility staff is under the influence while providing care and supervision to residents.
Complaint alleges that (1) staff person is regularly outside the facility smoking marijuana while providing care to the residents.

Staff (S1) stated to LPA's on 12/9/22 that he was told by the neighbor and the Administrator that he couldn't smoke marijuana even outside at the facility and has only smoked it away from the facility and on his day off only. S1 confirmed he has not smoked marijuana near the facility and there are no other staff or any residents that smoke marijuana. LPA's explained that staff needs to be able to provide the necessary care and supervision to the residents at all times and that if (S1) was not able to provide the adequate care and supervision, due to being under any chemical influence, he could be potentially excluded for life from ever working in a facility licensed by CCLD.

LPA Calzada and LPA Hood did not observe S1 to smell of marijuana smoke on 12/9/22. LPA Calzada toured the facility again on 1/11/23 and observed it to be free from any smoke odors. S1 was not at the facility during the inspection on 1/11/23 as it was his day off.

One resident who was interviewed on 12/09/22 stated.."staff has always been able to provide care" and (S1) has never smelled of smoke, has "no concerns" and stated "(S1) is a good guy". The same resident stated "staff is great " and "staff is never under the influence" of anything. A second resident stated that "(S1) does a great job- there are no problems" and has "never" observed (S1) to be under the influence of a drug or alcohol.

A family member who regularly visits resident (R3) stated on 1/4/23 that he is very familiar with S1 and has "never observed" (S1) to be under the influence of marijuana or alcohol and S1 and is "very attentive" and does a good job cleaning and preparing individual meals for all (6) residents, and he has only smelled tobacco smoke as some of the residents smoke outside on the back patio.

A neighbor who lives nearby the facility provided specific days/times when marijuana smoke was observed to be coming over the fence into her yard when S1 was working. The Department received additional information that marijuana smoke was coming from the facility patio on 12/28/22, but no evidence was able to be provided, including video surveillance, showing the smoke was coming from the neighboring facility.

cont on 9099C-2...

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina Calzada	TELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 25-AS-20221201084111

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: COUNTRY OAKS MANOR	FACILITY NUMBER: 347002045
	VISIT DATE: 01/11/2023

NARRATIVE

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9099C-2... The Administrator stated he has "not personally seen (S1) smoking" at the facility and has told S1 he cannot smoke marijuana at the facility and while providing care/supervision to the residents. Administrator stated to LPA in a follow up discussion, on 12/29/22, that if he receives information that marijuana smoke is coming from the facility he will immediately follow up with S1. Administrator stated on 12/9/22 he has video surveillance on his phone and would check to see if (S1) was smoking marijuana while on duty. Administrator stated to LPA on 1/11/23 that he did not find any video surveillance showing S1 to be smoking at the facility.

Based on information obtained, LPA finds the allegation to be UNSUBSTANTIATED-

Allegation: Facility smells of marijuana.

A neighbor nearby the facility stated she has smelled marijuana smoke coming over the fence into her yard on many occasions prior to 12/1/22 for over a year, off and on. The Department was provided with updated information that marijuana smoke was smelled coming from outside the facility on 12/24/22, 12/26/22 and on 12/28/22. LPA Calzada and LPA Hood toured the interior of the facility on 12/9/2023 and did not observe the facility to smell of marijuana or smoke. LPA's observed the windows in (2) resident rooms (1 was vacant) to be half open and each room to have a bottle of air freshener in the room. LPA's observed ash trays in the outside patio area and observed (2) residents to be smoking tobacco cigarettes outside during the inspection. One resident who was interviewed stated that residents that smoke will go outside to smoke. LPA Calzada toured the facility again on 1/11/23 and did not observe any smoke odors inside or outside.

Administrator stated he has not personally observed staff, S1, to ever smoke at the facility and has discussed with S1 how smoking marijuana while working with residents it not allowed. A family member who regularly visits resident (R3) stated he has only smelled tobacco smoke as some of the residents smoke outside on the back patio. The Administrator stated on 12/29/22 that he is at the facility everyday and didn't notice anything about staff smoking marijuana. One resident who was interviewed stated that residents that smoke will go outside to smoke. A second resident stated he has never smelled marijuana smoke inside or outside of the facility and has never observed (S1) to smell of smoke or marijuana.

Based on information obtained, LPA finds the allegation to be UNSUBSTANTIATED- A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview. Copy of report provided to Administrator.

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina Calzada	TELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

LIC9099 (FAS) - (06/04)

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