392700366-3-25-2021-27-AS-KHOS-BZFQ7J-20210325115512

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392700366
Report Date: 03/25/2021
Date Signed: 03/25/2021 10:17:32 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
11/24/2020 and conducted by Evaluator Bruce Jacobs

COMPLAINT CONTROL NUMBER: 27-AS-20201124135104

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:	03/25/2021
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Maureen Bradley, Executive Director		TIME COMPLETED:	09:15 AM

ALLEGATION(S):

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Staff failed to protect resident from harm while in care due to abuse or neglect.

Staff handle residents in a rough manner.

Insufficient staff to meet the needs of the residents.

INVESTIGATION FINDINGS:

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LPA Bruce Jacobs delivered complaint findings for the allegations listed above to Maureen Bradley, Executive Director of the facility.

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 facility and resident records were requested, obtained and reviewed. The investigation was unable to prove with a preponderance of evidence that the facility staff failed to protect resident (R-1) from harm while in care due to abuse or neglect. The interviews and records provided conflicting statements and witnesses did not provide information to support the above allegations. Regarding the staff handling residents (R-1,2) in a rough manner, LPA spoke with several residents, several staff, and other witnesses. There was not sufficient information obtained through interviews to support the allegation. Records and interviews also did not provide evidence to prove there were not sufficient staff to meet the residents' needs.

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: 03/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2021

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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