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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347003743
Report Date: 08/24/2022
Date Signed: 08/24/2022 10:39:53 AM

Substantiated


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
08/03/2022 and conducted by Evaluator Kevin Mknelly
COMPLAINT CONTROL NUMBER: 25-AS-20220803094857
FACILITY NAME:WALNUT HOME CAREFACILITY NUMBER:
347003743
ADMINISTRATOR:OLTEAN, MARIANAFACILITY TYPE:
740
ADDRESS:4120 WALNUT AVENUETELEPHONE:
(916) 718-6870
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:6CENSUS: 6DATE:
08/24/2022
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Diane OlteanTIME COMPLETED:
10:50 AM
ALLEGATION(S):
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Resident denied visitation
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kevin Mknelly arrived at the facility unannounced on 8/ /22 to deliver complaint findings. LPA met with Diane Oltean and explained the purpose of the visit. Prior to initiating the complaint visit, LPA completed the department's required COVID-19 testing and screening protocols. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA was screened by facility staff upon entering the facility.
The department reviewed client/resident records and conducted extensive interviews.

On 6/24/2022, a family member ( FM1) of R1 attempted to visit R1 at the facility. FM1 alleged staff S1 would not allow the FM1 into the facility based on POA instruction and when S1 showed R1 FM1 photo id, S1 reportedly told FM1 that R1 does not recognize her. S1 stated that R1 seemed to recognize FM1 and stated "no" to wanting to have FM1 visit. The staff then called R1’s POA and informed him that FM1 was at the facility requesting to visit R1. POA arrived at the facility and blocked the facility door, so that
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin MknellyTELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022
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 4
Control Number 25-AS-20220803094857
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: WALNUT HOME CARE
FACILITY NUMBER: 347003743
VISIT DATE: 08/24/2022
NARRATIVE
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FM1 could not enter into the facility. Latter on 6/24/22 at temporary restraining order was issued for FM1 to not visit R1.

On 8/11/22, LPA interviewed R1 in her room. R1 has advanced dementia and very limited verbal interaction skills. LPA looked at a family photo of R1 and her family with R1. R1 was not able to verbally state the name or relationship of her to anyone in the photo except “my husband” when staff pointed at him.

Facility records provided found R1 had granted POA financial powers in 1999. Powers to restrict visitation was not found in the document at the facility.

POA provided the following documents to LPA on 8/17/22: 1995 temporary restraining order from R1 for POA (financial) 1999, Do not visit letter from R1 to family member attempting to visit 2007; Typed letter from R1 to her prior facility asking facility to restrict FM1 visits 2017; a hand written note from R1 to the same facility to restrict FM1 visits 2019. LPA is unable to verify the authenticity of the documents.

The department’s guidance, as presented in Provider Information Notice PIN 21-48-ASC Authority of Conservators and Agents Under Powers of Attorney Related to Residents' Rights, for such circumstances is that while both a POA and a conservatorship give one person the authority to make decisions for another person, the extent of that authority varies. POA agents are limited to the powers granted in the POA document. POAs typically do not address issues concerning visitation, telephone calls, or personal mail and therefore, agents are not authorized to restrict these rights. However, a POA agent can regulate visitation, telephone calls or personal mail only if: 1) the resident explicitly gave the agent the authority to regulate these issues in the POA and 2) the principal does not disagree with the choices the agent is making. Principals, even those with a cognitive impairment, retain the legal authority to control their health care and other personal decisions unless a court has taken that authority away. [Probate Code section 4689]
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin MknellyTELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 25-AS-20220803094857
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: WALNUT HOME CARE
FACILITY NUMBER: 347003743
VISIT DATE: 08/24/2022
NARRATIVE
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The law specifically prohibits conservators from restricting visitors, telephone calls and personal mail unless there is express court approval. [Probate code section 2351]

If licensees have concerns about a resident's visitors, telephone calls, and personal mail being disruptive, abusive, or threatening in nature, the department advises the licensee to seek assistance from local law enforcement.

Therefore, on 6/24/22, FM1 was restricted from visitation to R1. R1 was not provided an opportunity in a manner within her current abilities to accept or decline the visit.

As a result of this investigation, LPA finds allegation to be (S) Substantiated - A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. The following deficiencies were cited on 9099-D, per Title 22 Regulations, Division 6. (A)This poses an immediate Health and Safety risk to clients/residents in care. (B) This poses a potential Health and Safety risk, or personal rights violation, to clients/residents in care.



Report summarized by phone with Diane Oltean. Signature received by caregiver . Copy of this report and appeal rights provided.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin MknellyTELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4
Control Number 25-AS-20220803094857
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: WALNUT HOME CARE
FACILITY NUMBER: 347003743
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/24/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
09/07/2022
Section Cited
CCR
87468.1(a)(1)
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Personal Rights of Residents in All Facilities (11) To have their visitors, including ombudspersons and advocacy representatives, permitted to visit privately during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon.
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Licensee will submit a statement of understanding of resident rights vs POA powers limitations when determining resident visitation, by the POC date of 9/7/22.
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This requirement was not met based on records and interviews finding POA did not have standing to restrict visits and R1 was not allowed a visit.
This violated R1’s personal rights.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin MknellyTELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4