347003507-12-22-2022-27-AS-KHOS-CMLTPM-20221230135431

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347003507
Report Date: 12/22/2022
Date Signed: 12/22/2022 01:09:20 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, 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
09/19/2022 and conducted by Evaluator Christina Valerio

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20220919152255

FACILITY NAME:	VICIO CARE HOME		FACILITY NUMBER:	347003507
ADMINISTRATOR:	VICIO, LEA M.		FACILITY TYPE:	740
ADDRESS:	9063 WHARTON WAY		TELEPHONE:	(916) 689-8012
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	6	CENSUS: 6	DATE:	12/22/2022
		UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Lea Vicio		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Neglect

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christina Valerio arrived to the facility unannounced to deliver complaint investigation findings. LPA met with facility staff, and explained the purpose of the visit. LPA has determined the following as it relates to the above-mentioned allegation.

LPA Valerio observed the facility on two occasions. During both occasions, the facility had two staff members present while residents were engaging in personal activities. Staff interactions with residents were observed to be professional, supportive, and encouraging. The facility had pantry shelves stocked with snacks, canned items, and perishable goods. The refrigerator and freezer were stocked with a minimum of 7 days of perishable foods and 2 days worth of perishable food items. Resident mood appeared to be in good spirits as evidenced by smiling, having positive interactions, and open body language.

Continues on LIC 9099 - C...
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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Christina Valerio	TELEPHONE: 916-823-6323
LICENSING EVALUATOR SIGNATURE:	DATE: 12/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2022

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-20220919152255

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: VICIO CARE HOME	FACILITY NUMBER: 347003507
	VISIT DATE: 12/22/2022

NARRATIVE

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...Continued from LIC 9099
An outside agency conducted health and safety visits to observe the facility. According to their visits, they did not observe any evidence to prove staff were neglecting the residents.

LPA Valerio conducted interviews. According to staff interviews, there has never been any signs of neglect from other staff nor did the staff admit to any form of neglect. Staff informed LPA that each resident has a section in the pantry with snacks, which they have full access at any time of the day. According to staff, staff provide 3 meals and snacks in between.

According to facility on-going notes, staff document the amount eaten for each resident. LPA did not observe any meal times missed, unless the resident was out on an outing with family and/or in the hospital.

According to information obtained from interviews five residents , residents enjoy the food, say they like living here, and did not mention any signs of neglect from staff. Residents who were unable to communicate with LPA appeared content and not in distress.

According to interviews with a family member, they do not know if staff neglected the residents; however, they had concerns with their loved one's weight. When they brought the concern up with family, the administrator made appropriate steps to ensure their concern was looked into. According to the interview, the family is happy with the facility. This incident resulted in a staff member being removed from the facility and the implementation of a 4th meal time for the resident. LPA reviewed resident's records. According to records, records show a difference of 10lbs since the date of admission to current and a prior diagnosis that may contribute to weight loss. According to an interview with family, the difference of culture/home environment may also be a contributing factor to weight loss. According to the administrator, the staff member was removed because of an allegation. Administrator could not confirm whether that staff did or did not refuse to give food. According to staff, the staff provided all meals and stated residents loved the staff's cooking. According to the administrator, interactions with all staff and residents have been professional and no behaviors indicate neglect by staff.

Due to the above noted information, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, and therefore the allegations are unsubstantiated. Per California Code of Regulations (CCRs) - Title 22, no deficiencies cited. Exit interview was held facility staff Conrado Camma and Administrator Lea Vicio via cell, and a copy of report was left at the facility.

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Christina Valerio	TELEPHONE: 916-823-6323
LICENSING EVALUATOR SIGNATURE:	DATE: 12/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2022

LIC9099 (FAS) - (06/04)

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