347003857-10-12-2023-27-AS-KHOS-CX5MUE-20231031095500

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347003857
Report Date: 10/12/2023
Date Signed: 10/12/2023 11:14:49 AM

Unfounded

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
05/26/2023 and conducted by Evaluator Kevin Gould

COMPLAINT CONTROL NUMBER: 27-AS-20230526110229

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: 4	DATE:	10/12/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Melinda Munar		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Neglect/Lack of Supervision:
1) Staff do not assist Resident with bathing
2) Staff does not ensure that resident's hygiene needs are met
Medication:
1) Staff is providing medication to resident without the required authorization.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kevin Gould made an unannounced inspection to the Ranum's Care Home (RCFE) on 10/12/23 at 9:00am to conclude the investigation of the above allegations and to deliver the findings. LPA met with Administrator and together discussed the investigation details.

Based on the interviews conducted and statements obtained during the investigation process, the allegations cannot be corroborated. LPA reviewed resident's files and observed documentation by the hospice agency that the hospice agency is providing alleged victim with three bed baths per week. LPA was able to confirm that resident was receiving assistance with bathing while at the facility and the documetnation was available for LPA to review. In addition, LPA conducted interview with A1 who is a friend of the resident who denied having any concerns about the care provided and resident always appeared clean and well groomed. LPAs observations of resident was she appeared clean and well groomed at the time of inspection. LPA was unable to conduct interview with resident as she had limited verbal response.
Report Continued on LIC 9099-C

Unfounded

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: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

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 4

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
05/26/2023 and conducted by Evaluator Kevin Gould

COMPLAINT CONTROL NUMBER: 27-AS-20230526110229

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: 4	DATE:	10/12/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Melinda Munar		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Personal Rights:
1) Staff confines resident to wheelchair
2) Staff do not assist resident with grooming
3) Staff keeps residents confined indoors
4) Licensee is preventing resident from having visitors.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kevin Gould made an unannounced inspection to the Ranum's Care Home (RCFE) on 10/12/23 at 9:00am to conclude the investigation of the above allegations and to deliver the findings. LPA met with Administrator and together discussed the investigation details.

Based on the interviews and statements obtained during the investigation process, the allegations cannot be substantiated. LPA observed the resident during an inspection on 6/1/23 and observed the resident to be cleaned and well groomed. LPA was unable to obtain any evidence of resident being not groomed by staff. Staff interviewed denied the allegation and A2 expressed no concerns for R1 and was happy with the care received. Other resident interviewed states staff will assist with grooming daily. This allegation is unsubstantiated. Regarding denying visitors, LPA was unable to corroborate the allegation as only one individual claimed to being denied access to resident. Other resident interviewed denied the allegations and sates thee are regular visitors. Report Continued on LIC 9099-C.

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: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 27-AS-20230526110229

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: 10/12/2023

NARRATIVE

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Staff interviewed claimed individual who was denied entry was aggressive and disruptive to other residents and did not treat staff with respect. A2 was interviewed and denied being unable to visit R1. Regarding being confined to wheelchair, LPA only observed the resident once and observed the resident in a wheelchair. Resident had hip surgery in December 22 and was on hospice and continued decline and was unable to walk much. R1 did have a gait belt, it was not secure to the wheelchair and was only for staff to assist in getting resident up from wheelchair or seated position. LPA was unable to obtain any evidence that R1 was confined to wheelchair by staff. Additionally, Reporting party alleged that R1 was confined to indoors only, and LPA was unable to corroborate the allegation. RP reported that staff protested to him taking resident in the back yard. Staff interviewed stated that resident had severe allergies and going outside would exacerbate her allergies and negatively impacted R1's COPD. Staff did not have a PRN for allergy medication. R1 could not be interviewed due to limited verbal response.

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 personal rights 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, DIVISION 6.

Exit interview was conducted with the facility Licensee. 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: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 27-AS-20230526110229

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: 10/12/2023

NARRATIVE

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Regarding the allegation that R1 was administered medications without physician authorization, LPA was able to review documentation of multiple physician orders or a PRN of cough syrup to help alleviate symptoms from chromic lung disease (COPD). LPA was able to confirm resident had a physician's order for medication administered to resident. Medication records indicate the PRN was administered in accordance with directions.

The Department has investigated the complaint alleging Neglect/Lack of Supervision and Medication.Based on the investigative interviews, record reviews and other supportive evidence, the complaint is determined to be unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. The Complaint has been dismissed.

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

Exit interview was conducted with the facility Licensee 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: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 4