347004430-4-19-2023-59-AS-MSEY-CR3M25-20230420091255

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347004430
Report Date: 04/19/2023
Date Signed: 04/19/2023 05:00:02 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 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
03/28/2023 and conducted by Evaluator Sabrina Calzada

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20230328174026

FACILITY NAME:	POPO'S PLACE		FACILITY NUMBER:	347004430
ADMINISTRATOR:	RACHEL MILES		FACILITY TYPE:	740
ADDRESS:	7672 EASTGATE AVENUE		TELEPHONE:	(916) 961-6248
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY:	6	CENSUS: 5	DATE:	04/19/2023
		UNANNOUNCED	TIME BEGAN:	03:10 PM
MET WITH:	Kim Rosa, Co-Administrator		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Residents are chemically restrained with medication
Facility staff not fingerprint-cleared
Staff are using drugs while on duty
Facility staff are abusing residents

INVESTIGATION FINDINGS:

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LIcensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to complete and deliver findings to a complaint received on 3/28/23. LPA met with Euretha Micheli, caregiver, and explained purpose of inspection. LPA spoke to Kim Rosa, House Manager, by phone, who arrived at 3:20 pm.. LPA completed required COVID-19 department protocols and was wearing a surgical mask. LPA observed (3) residents watching television in the common area and (2) residents in their rooms.

LPA interviewed the Administrator, (2) caregivers and (2) residents and reviwed medication orders for (2) residents. LPA also toured the facility and observed all residents on 4/5/23 and on 4/19/23. The results of the investigation are as follows:

Allegation: Residents are chemically restrained with medication. All staff and resident interviews indicated that residents are only administered medications that are ordered and generally sleep through the night. Caregiver interviews and medication review showed that (1) resident (R1) takes Trazadone, which can cause drowsinesss, as a scheduled medication and (2) residents (R2 and R3) take Trazadone as a PRN. LPA observed ordered medications to be given as ordered and no errors for residents (R1 and R4) . Facility to conduct refresher medication training on documentation and using the correct start date. Also, facility is correctly documenting the PRN medications but will train on this also.

***cont on 9099C(1)..

Unfounded

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: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

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 59-AS-20230328174026

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

FACILITY NAME: POPO'S PLACE	FACILITY NUMBER: 347004430
	VISIT DATE: 04/19/2023

NARRATIVE

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9099C(1). Based on information obtained, LPA finds the allegation to be UNFOUNDED-means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Allegation: Facility staff not fingerprint- cleared. LPA reviewed staff files for (2) staff, including photo ID, and observed that both staff are fingerprinted cleared and associated. Additionally, Co-Administrator is fingerprint cleared and associated.

Based on information obtained, LPA finds the allegation to be UNFOUNDED- means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Allegation: Staff are using drugs while on duty. Complaint alleges that staff are using drugs while on duty.
Based on interviews with staff and residents and LPA's observations on 4/4/23 and on 4/19/23, and also in February and March 2023, staff were observed to be competently assisting residents and able to perform their jobs.

Based on information obtained, LPA finds the allegation to be UNFOUNDED- means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Allegation: Facility staff are abusing residents.

Based on interviews with staff and residents and LPA's observations on 4/4/23 and on 4/19/23, staff are not abusing or neglecting residents. Residents who were able to be interviewed stated staff provides excellent care and assists them well. LPA observed (3) residents watching television during all inspections and didn't observe any physical bruising on any residents.

Based on information obtained, LPA finds the allegation to be UNFOUNDED- means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview. Copy of report provided to Co-Administrator.

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina Calzada	TELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

LIC9099 (FAS) - (06/04)

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