347003857-4-3-2023-27-AS-KHOS-CQUHTQ-20230413062908

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347003857
Report Date: 03/30/2023
Date Signed: 04/03/2023 07:37:36 AM

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
12/13/2022 and conducted by Evaluator Kevin Gould

COMPLAINT CONTROL NUMBER: 27-AS-20221213145137

FACILITY NAME:	RANUM'S CARE HOME		FACILITY NUMBER:	347003857
ADMINISTRATOR:	MUNAR, MELINDA		FACILITY TYPE:	740
ADDRESS:	3400 VIKING DRIVE		TELEPHONE:	(916) 882-4116
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95827
CAPACITY:	6	CENSUS:	DATE:	03/30/2023
		UNANNOUNCED	TIME BEGAN:	02:19 PM
MET WITH:	Lucrecia Navidad		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Neglect/Lack of Supervision: Faciltiy failed to have resident medically treated in a timely manner

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kevin Gould made an unannounced inspection to the Ranum's Care Home (RCFE) on 3/30/23 at 2:10pm to conclude the investigation of the above allegation and to deliver the findings. LPA met with staff and together discussed the investigation details.

Based on the interviews and statements obtained during the investigation process, the allegations cannot be substantiated because of conflicting statements obtained from staff and home health agency and the length of time from when the resident was admitted tot he hospital in November and the when the department received the complaint. Per resident records, R1 was sent to the hospital on 11/26/22 for concerns unrelated to the complaint. Home health interviewed stated to LPA that they did not observe any rash or unknown skin issues the day prior to R1 being sent to the hospital. both staff interviewed denied witnessing any rashes or skin issues for resident prior to being admitted to the hospital. Several weeks after resident was admitted the department received concerns regarding a scabies infection fro R1. Hospital staff reviewed R1's intake and there was no observed rashes or skin concerns identified at resident's intake.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Czarrina A Camilon-Lee	TELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Kevin Gould	TELEPHONE: (619) 672-5924
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023

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-20221213145137

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: RANUM'S CARE HOME	FACILITY NUMBER: 347003857
	VISIT DATE: 03/30/2023

NARRATIVE

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The department did not receive any complaints regarding scabies until R1 had been at the hospital for several weeks. The department is unable to corroborate the allegation as LPA was unable to obtain any preponderance of evidence to suggest resident obtained scabies and went untreated at the facility prior to admission to the hospital.
Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has determined that the allegations of (indicate the complaint allegation) are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed.

There are no deficiencies noted or cited per California Code Regulation, TITLE 22.

Exit interview was conducted with the facility staff. Appeal Rights were issued, and a copy of this report was left at the facility.

SUPERVISOR'S NAME: Czarrina A Camilon-Lee	TELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Kevin Gould	TELEPHONE: (619) 672-5924
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023

LIC9099 (FAS) - (06/04)

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