392700366-3-19-2021-27-AS-KHOS-BZFKGA-20210325075314

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392700366
Report Date: 03/19/2021
Date Signed: 03/19/2021 11:07:54 AM

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
11/10/2020 and conducted by Evaluator Bruce Jacobs

COMPLAINT CONTROL NUMBER: 27-AS-20201110091314

FACILITY NAME:	COMMONS AT UNION RANCH, THE		FACILITY NUMBER:	392700366
ADMINISTRATOR:	MAUREEN BRADLEY		FACILITY TYPE:	740
ADDRESS:	2241 N UNION ROAD		TELEPHONE:	(209) 463-9100
CITY:	MANTECA	STATE: CA	ZIP CODE:	95336
CAPACITY:	135	CENSUS: 92	DATE:	03/19/2021
		UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Maureen Bradley, Executive Director		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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9

Staff yelled at resident.

Food is not of adequate quality.

INVESTIGATION FINDINGS:

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2
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13

LPA Bruce Jacobs and made an unannounced visit to deliver complaint findings for the allegation listed above. LPA met with Maureen Bradley, Executive Director and explained the purpose of the visit.

The investigation was conducted by LPA Jacobs consisted of interviews with the Executive Director, facility staff, residents and other witnesses at the care home. Facility site inspections were conducted and records were reviewed and copies of pertinent documents including menus and staffing records were obtained for the complaint record. The investigation was unable to prove with a preponderance of evidence that the facility staff (S-1) yelled at the resident (R-1)as the individuals involved provided conflicting statements and witnesses do not provide information to support the allegation. Regarding the food not being of adequate quality, LPA spoke with several residents, several staff, observed a meal and obtained copies of recent While residents were unhappy with tray services to their rooms for an extended time period due to health official's guidance, there is not sufficient evidence to prove the quality of food was inadequate. In addition, residents have reported greater satisfaction now that dining is allowed again.

This agency has investigated the above listed allegation and determined that there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, we have found the allegations to be UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Liza King	TELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Bruce Jacobs	TELEPHONE: (916) 956-5861
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2021

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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