347005332-3-10-2023-59-AS-MSEY-CPWMJ6-20230314093834

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347005332
Report Date: 03/10/2023
Date Signed: 03/10/2023 05:00:30 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
03/03/2023 and conducted by Evaluator Kevin Mknelly

COMPLAINT CONTROL NUMBER: 59-AS-20230303080318

FACILITY NAME:	CHRISMAN COMMUNITY		FACILITY NUMBER:	347005332
ADMINISTRATOR:	CLAUDIA MIHAI		FACILITY TYPE:	740
ADDRESS:	4230 PARADISE DRIVE		TELEPHONE:	(916) 515-8590
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	0	CENSUS: 0	DATE:	03/10/2023
		UNANNOUNCED	TIME BEGAN:	03:45 PM
MET WITH:	Claudia Hahai		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff does not ensure residents receive assistance with activities of daily living

Staff does not ensure residents special dietary restrictions are being followed

Staff does not ensure food is of good quality

INVESTIGATION FINDINGS:

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On 3/10/23, Licensing program Analyst (LPA) arrived unannounced at this home that was licensed to a new licensee on 3/2/23. LPA explained the reason for the visit.

As this licese closed a day before the complaint intaks, the allegations have been transferred to the licensed care home where the allegations were alleged to have occurred. These allegations will be investigated by the department.

As the complaint was taken for the incorrect facility, the allegations are unfouded for this facility.

No deficencies are found for this facility.

Report reviewed and copy provided.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin Mknelly	TELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2023

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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