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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700640
Report Date: 06/03/2024
Date Signed: 06/10/2024 10:13:52 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/24/2024 and conducted by Evaluator Albert Johnson
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20240424143520
FACILITY NAME:COURTYARD AT RIO LAS PALMAS, THEFACILITY NUMBER:
392700640
ADMINISTRATOR:GUERRERO, LIZETHFACILITY TYPE:
740
ADDRESS:877 EAST MARCH LANETELEPHONE:
(209) 957-4711
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY:80CENSUS: 59DATE:
06/03/2024
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:L. GuerreroTIME COMPLETED:
03:40 PM
ALLEGATION(S):
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Facility staff are not assisting resident with bathing
INVESTIGATION FINDINGS:
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On this 6/3/2024, LPA Johnson delivered findings for the above allegation.

Based on records review, interviews with staff, residents in care, and RP. It was determined by the department that facility records indicate that residents did get their scheduled showers. Resident (R1) has refused showers in the past and confirmed that a staff that is no longer working at the facility would encourage R1 to wait until the next shift or the next day on some occasions to take a shower. R1 stated that she believes this is because that staff did not want to assist in helping to take a shower. Staff interviewed state that residents in the care get showers twice a week or as necessary. Residents interviewed state they did get showers twice a week or as necessary.
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Albert JohnsonTELEPHONE: (916) 217-1390
LICENSING EVALUATOR SIGNATURE:

DATE: 06/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 27-AS-20240424143520
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: COURTYARD AT RIO LAS PALMAS, THE
FACILITY NUMBER: 392700640
VISIT DATE: 06/03/2024
NARRATIVE
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Based on records review, interviews with staff, residents, and the Administrator. The department is unclear if all staff are assisting resident with bathing. The staff in question is no longer working at the facility and there is no other evidence to confirm the allegation. Therefore the allegation is UNSUBSTANTIATED.
SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Albert JohnsonTELEPHONE: (916) 217-1390
LICENSING EVALUATOR SIGNATURE:

DATE: 06/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2