347002787-8-6-2020-27-AS-LMUZ-BT3NER-20200902102419

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347002787
Report Date: 08/06/2020
Date Signed: 08/06/2020 01:32:10 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/24/2020 and conducted by Evaluator Michael Hood

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20200724111330

FACILITY NAME:	CARLTON PLAZA OF SACRAMENTO		FACILITY NUMBER:	347002787
ADMINISTRATOR:	LISA SCHUMANN		FACILITY TYPE:	740
ADDRESS:	1075 FULTON AVENUE		TELEPHONE:	(916) 971-4800
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95825
CAPACITY:	185	CENSUS: 127	DATE:	08/06/2020
		UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Lisa Schumann, Administrator		TIME COMPLETED:	01:50 PM

ALLEGATION(S):

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Facility has pests

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Michael Hood contacted Administrator Lisa Schumann via telephone to deliver findings for a complaint investigation of violation of physical plant. This visit was conducted via telephone due to COVID-19 and precautionary measures.

Allegation: Facility has pests – Unfounded

Staff interviews indicated that cockroaches have been observed at the facility as recent as 7/31/2020, but discoveries of pests were reported to management. Facility contracted a pest control company and regular sprayings for pests have been observed by staff members. Administrator sent LPA monthly pest control invoices from February of 2020 through July of 2020. No pests were observed by LPA during tele-visit conducted on 7/30/2020.

** Report continued on 9099-C **

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 243-4743
LICENSING EVALUATOR NAME: Michael Hood	TELEPHONE: (916) 531-7341
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2020

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-20200724111330

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

FACILITY NAME: CARLTON PLAZA OF SACRAMENTO	FACILITY NUMBER: 347002787
	VISIT DATE: 08/06/2020

NARRATIVE

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Based on documents reviewed and interviews conducted, the facility was found to have pests. However, the facility has taken steps to remedy the pest issue by having pest control service the property. This agency has found the complaint allegations to be UNFOUNDED, meaning that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview was conducted with Administrator via telephone and a copy of this report will be provided to the facility via email. This facility shall sign and return a copy of the report to CCL and print a copy to be retained by the facility.

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 243-4743
LICENSING EVALUATOR NAME: Michael Hood	TELEPHONE: (916) 531-7341
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2020

LIC9099 (FAS) - (06/04)

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