347005529-2-25-2021-27-AS-KHOS-BYQJ46-20210302054236

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347005529
Report Date: 02/25/2021
Date Signed: 02/25/2021 02:44:49 PM

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
08/31/2020 and conducted by Evaluator Anthony Tuck

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20200831162506

FACILITY NAME:	MEADOWS SENIOR LIVING, THE		FACILITY NUMBER:	347005529
ADMINISTRATOR:	STEPHANIE JOHNSON-YANCY		FACILITY TYPE:	740
ADDRESS:	9325 E STOCKTON BLVD		TELEPHONE:	(916) 714-3755
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	160	CENSUS: 74	DATE:	02/25/2021
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Barbara Fleck		TIME COMPLETED:	02:41 PM

ALLEGATION(S):

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Staff denied home health nurse to visit their client.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Anthony Tuck contacted the facility via telephone and spoke with Executive Director (ED) Barbara Fleck to conclude a complaint investigation on 2/25/2021 due to COVID-19 and pre-cautionary measures. LPA identified himself and discussed the purpose of the call and the elements of the allegation with ED Barbara Fleck.

The allegation is the staff denied home health nurse to visit their client.
Based upon LPA's interviews with RP and prior ED and review of documentation received and reviewed, LPA learned that the facility followed measures for infection control prevention. The preponderance of evidence standards was not met, therefore, the above allegation is found to be UNFOUNDED. An unfounded allegation means that the allegation was false, could not have happened and/or is without a reasonable basis. LPA Tuck conducted an exit interview. LPA Tuck emailed Barbara a copy of the report to review, sign, and send back. A signed copy of this report will be stored in the facility file.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (209) 242-5200
LICENSING EVALUATOR NAME: Anthony Tuck	TELEPHONE: (916) 708-6203
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2021

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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