392700640-1-26-2023-27-AS-KHOS-CNNL8K-20230202073201

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392700640
Report Date: 01/26/2023
Date Signed: 01/26/2023 02:56:25 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO AC/SC, 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
01/18/2023 and conducted by Evaluator Kesha Lewis

COMPLAINT CONTROL NUMBER: 27-AS-20230118144555

FACILITY NAME:	COURTYARD AT RIO LAS PALMAS, THE		FACILITY NUMBER:	392700640
ADMINISTRATOR:	GUERRERO, LIZETH		FACILITY TYPE:	740
ADDRESS:	877 EAST MARCH LANE		TELEPHONE:	(209) 957-4711
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95207
CAPACITY:	80	CENSUS: 131	DATE:	01/26/2023
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Lizeth Guerrero		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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9

Facility elevator is in disrepair

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kesha Lewis arrived to investigate a complaint. LPA met with Executive Director Lizeth Guerrero and explained the purpose of the visit.

LPA took copies of elevator trouble call logs and invoices from TKE elevator. There are 3 elevators in the facility and elevator 1 is in question. Elevator 1 was turned off by facility staff on 01/03/2023 and 01/19/2023, TKE elevator was called the same day to come for repairs. LPA took copies of most current invoices from TKE elevator they are billed with a month lead time.

Therefore, this complaint is UNSUBSTANTIATED. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

No deficiencies were cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with facility director and a copy of this report will be emailed to the facility as LPA'S printer is not working at this time.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Liza King	TELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Kesha Lewis	TELEPHONE: (650) 676-0552
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO AC/SC, 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
01/18/2023 and conducted by Evaluator Kesha Lewis

COMPLAINT CONTROL NUMBER: 27-AS-20230118144555

FACILITY NAME:	COURTYARD AT RIO LAS PALMAS, THE		FACILITY NUMBER:	392700640
ADMINISTRATOR:	GUERRERO, LIZETH		FACILITY TYPE:	740
ADDRESS:	877 EAST MARCH LANE		TELEPHONE:	(209) 957-4711
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95207
CAPACITY:	80	CENSUS:	DATE:	01/26/2023
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:			TIME COMPLETED:	03:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

INVESTIGATION FINDINGS:

1
2
3
4
5
6
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9
10
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12
13

Exit interview conducted with facility administrator and a copy of report given.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Liza King	TELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Kesha Lewis	TELEPHONE: (650) 676-0552
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO AC/SC, 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
01/18/2023 and conducted by Evaluator Kesha Lewis

COMPLAINT CONTROL NUMBER: 27-AS-20230118144555

FACILITY NAME:	COURTYARD AT RIO LAS PALMAS, THE		FACILITY NUMBER:	392700640
ADMINISTRATOR:	GUERRERO, LIZETH		FACILITY TYPE:	740
ADDRESS:	877 EAST MARCH LANE		TELEPHONE:	(209) 957-4711
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95207
CAPACITY:	80	CENSUS: 131	DATE:	01/26/2023
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Lizeth Guerrero		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

1
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3
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5
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7
8
9

Facility is malodorous

INVESTIGATION FINDINGS:

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13

LPA spoke with house keeping manager and Executive Director regarding sanitation procedures. LPA observed the facility to be free of odor, clean and in good repair on this date.

LPA took copies of the house keeping cleaning schedule. LPA observed the facility bathrooms clean. LPA did not observed the facility to be malodorous. LPA observed house keeping staff working at the facility.

The department has investigated the complaint allegations. We have found the complaint was UNFOUNDED, A finding of UNFOUNDED means that the allegation is false, could not have happened, and/or is without a reasonable basis.

No deficiencies cited

Exit interview conducted.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Liza King	TELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Kesha Lewis	TELEPHONE: (650) 676-0552
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 3