392700473-11-22-2022-27-AS-LKIG-CLFLDQ-20221123074018

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392700473
Report Date: 11/18/2022
Date Signed: 11/22/2022 04:00:23 PM

Unfounded

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
08/11/2022 and conducted by Evaluator Charlie Yang

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20220811131411

FACILITY NAME:	MANTECA RTRMT COM-HAPPY LVNG BY COGIR/COGIR MANTEC		FACILITY NUMBER:	392700473
ADMINISTRATOR:	SHERYL BRAVO		FACILITY TYPE:	740
ADDRESS:	430 NORTH UNION RD		TELEPHONE:	(209) 823-0164
CITY:	MANTECA	STATE: CA	ZIP CODE:	95337
CAPACITY:	84	CENSUS: 59	DATE:	11/18/2022
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Sheryl Bravo		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Facility not following Covid 19 Mitigation Plan.

INVESTIGATION FINDINGS:

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Unannounced complaint visit made out to this facility on 11/18/2022 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator Sheryl Bravo who was briefly interviewed.
Current census was 59 residents.
The purpose of this complaint visit was to deliver the findings of this investigation to this facility and it's facility designated Administrator Sheryl Bravo.
Based on interviews, it was learned that this facility implemented a revised approach to how it conducted meals, activities, and community events where it affected the residents the most. It was learned that the dining hall was restricted, per the facility mitigation plan, for social distancing to only allow (2) residents at a dining table versus the usual (4) that was allowed prior to the public health orders. Meals were still sent up to the resident rooms if they desired to partake of them in their own private space. In addition, it was learned that many residents would come down to retrieve their meals but retreated back to their rooms to eat them.
Based on interviews, it was learned that activities were also limited. Social distancing was always observed with no touch interactions for bingo, exercises, and weekly poker gatherings to no more than 10 participants

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Charlie Yang	TELEPHONE: (916) 709-6507
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2022

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 27-AS-20220811131411

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

FACILITY NAME: MANTECA RTRMT COM-HAPPY LVNG BY COGIR/COGIR MANTEC	FACILITY NUMBER: 392700473
	VISIT DATE: 11/18/2022

NARRATIVE

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at a time.
It was learned that activity packets were delivered by facility staff to the residents and went door-to-door to achieve this goal. Facility staff attempted to remain present and active in the lives of the residents.
Based on interviews conducted, it was learned that due to the risk for COVID and COVID related illnesses all major community events and gatherings were cancelled. This was true for the gatherings that were usually held for holiday events. One such event was Halloween. Facility administrative staff decided to forego this event and did not host any Halloween related gatherings.
Based on further interviews, it was learned that even though residents were restricted in activities and community gatherings they understood the nature and reasons behind these restrictions. Facility residents felt that this facility was only abiding by the public health orders and accepted that these practices had to be put into place for the safety of the residents and continued health of this community.

This agency has investigated the complaint allegation(s). This agency has found that the complaint was UNFOUNDED, meaning that the allegation(s) were false, could not have happened and/or was without a reasonable basis. This agency has therefore dismissed the complaint.

There were no deficiencies observed or cited during today’s complaint visit.

Exit Interview

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Charlie Yang	TELEPHONE: (916) 709-6507
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2022

LIC9099 (FAS) - (06/04)

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