347002889-8-16-2023-59-AS-KHOS-CUSHK6-20230817061526

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347002889
Report Date: 08/16/2023
Date Signed: 08/16/2023 01:27:28 PM

Unsubstantiated

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
06/22/2023 and conducted by Evaluator Sabrina Calzada

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20230622162753

FACILITY NAME:	GOLDEN CREST CARE CENTER		FACILITY NUMBER:	347002889
ADMINISTRATOR:	VICTOR BURACHEK		FACILITY TYPE:	740
ADDRESS:	8120 PATTON AVENUE		TELEPHONE:	(916) 725-6766
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY:	6	CENSUS: 3	DATE:	08/16/2023
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Victor Burachek, Administrator		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Facility staff failed to seek medical attention for resident in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conclude a complaint investigation. LPA met with Administrator, Victor Burachek and caregiver, Natalia Burachek and explained the purpose of the inspection. LPA observed (1) resident in the common area and (2) residents in their rooms.

During the inspection, LPA discussed the allegation with Administrator, (1) caregiver, Administrator-Designee, resident (R1) and (1) Ombudsman. LPA also reviewed pertinent documentation in resident's file.

The complaint alleges that facility staff neglected to take resident (R1) for medical treatment for an ongoing toenail fungal infection for several months and treatement was handled at the facility.

The results of the investigation are as follows:
Administrator stated that resident moved to the facility in August 2019 and had a podiatrist when he moved in but was not seen regularly as a patient due to the pandemic. Administrator's stated resident is not diabetic or prone to infections and the physician's reports do not indicate a diagnosis of either. In 2019, resident was more independent with bathing and other ADL's but since 2020, resident has needed additional assistance with bathing.
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: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

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 59-AS-20230622162753

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: GOLDEN CREST CARE CENTER	FACILITY NUMBER: 347002889
	VISIT DATE: 08/16/2023

NARRATIVE

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9099C-1.. Physician's report, dated 1/22/2020 notes resident needs assistance with all ADL's, including bathing, dressing, and toileting. Administrator stated resident suffered a stroke prior to moving to the facility and has not been able to use the left hand well.

Administrator stated on 6/28/23, he reached out to resident's primary care physician to request a referral to a podiatrist but the doctor's office is slow to respond. Administrator stated he cut resident's nails in the shower when resident requested it and was not able to contact the podiatrist due to not having a referral. Administrator stated on 6/28/23 to LPA "the fungus is not serious" and explained he made a second request last week and is still waiting for the doctor to schedule a phone appointment. The Administrator indicated the toe nail fungus appeared about 3 months ago, but the podiatrist has cancelled at least one appointment, and the resident was not always available to be taken to an appointment.

On 8/16/23, Administrator indicated that resident had recently became upset due to continual fungus on his toenail and removed the nail from one of the big toes himself. The Administrator called the podiatrist and resident was seen for an in-person appointment on 7/24/23 where the other big toe was removed, as the resident insisted, and creme was prescribed. Caregiver stated that resident never had a toe nail infection and he was never in pain and after the appointment on 7/24/23, she used creme prescribed for (2) days until the area was healed. Administrator-Designee stated she was not aware of resident having in infection.

Ombudsman conducted an inspection on 6/24/23 and noted that resident "seemed very well cared for and content", and there was "no indication he was in any pain from an infection, and he was wearing nice socks and shoes." Ombudsman stated the Administrator indicated resident has the typical toenail fungus on his toes, but his physician said there is no threatening foot infection. Resident stated to the Ombudsman he is well cared for at the facility.

LPA spoke with resident on 6/28/23 who stated that Administrator cut his toenails before he went on vacation in May and explained that his sister put some fungus creme on his toe on the affected right foot, while he was visiting her. Resident agreed to allow LPA to observe his foot without a sock on. LPA did not observe any swelling, inflammation, fungus, or discoloration in the nail area and resident confirmed he does not have any pain in the toenail area.

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: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

LIC9099 (FAS) - (06/04)

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Control Number 59-AS-20230622162753

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: GOLDEN CREST CARE CENTER	FACILITY NUMBER: 347002889
	VISIT DATE: 08/16/2023

NARRATIVE

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9099C-2.. Administrator stated he provides nail trimming and cleaning to non-diabetic residents as part of basic care. Administrator stated resident asked him to trim his nails on several occasions. Administrator contacted resident's physician's office during today's inspection to confirm that the facility staff can trim resident's toenails. LPA heard the staff at the doctor's office indicate that it is fine for facility staff to trim resident's nail.

Administrator provided LPA with different appointments resident (R1)was taken to or attended by phone:

7/12/23- neurologist
7/19/23, 8/1/23 and 8/3/23- dental appointment
9/7/23- scheduled appointment with PCP

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.

There was concern also expressed about sufficient staff remaining at the facility when one staff takes a resident to medical/dental appointments. Both administrator and caregiver confirmed that there is always at least (1) staff who stays at the facility with the other residents when the Administrator takes another resident to an appointment.

There was concern about activities also expressed. Administrator and caregiver stated they offer residents daily walks, television shows/movies, sporting events, holiday outings, church volunteering, movies, and residents will go on outings with families and friends on a regular basis.

Exit interview conducted with the Administrator.

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina Calzada	TELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

LIC9099 (FAS) - (06/04)

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