397003261-5-9-2022-27-AS-SDOB-CEGJYJ-20220516072802

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 397003261
Report Date: 04/29/2022
Date Signed: 05/09/2022 07:48:06 AM

Unsubstantiated

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
02/16/2022 and conducted by Evaluator Sarah Hurt

COMPLAINT CONTROL NUMBER: 27-AS-20220216165315

FACILITY NAME:	BROOKDALE TRACY		FACILITY NUMBER:	397003261
ADMINISTRATOR:	SARA MACKEDSY		FACILITY TYPE:	740
ADDRESS:	355 W GRANT LINE RD		TELEPHONE:	(209) 835-1000
CITY:	TRACY	STATE: CA	ZIP CODE:	95376
CAPACITY:	180	CENSUS: 118	DATE:	04/29/2022
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Business Office Coordinator Christina GoForth		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Facility does not provide a safe environment for residents
Staff are unprofessional
Facilty pendants do not work properly
Facility is short staffed
Facility does not provide a safe environment for residents

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sarah Hurt arrived at the facility unannounced on April 29 ,2022 at 10:30 a.m. to investigate a complaint on the above allegations. LPA met with facility Business Office Coordinator Christina GoForth and explained the purpose for today’s visit.

Regarding the allegation Facility does not provide a safe environment for residents. Based on LPA interviews and records reviewed the facility is providing a safe enviroment for residents. LPA inerviewed the facility Administrator Sara Mackedsy, 1 facility staff, and also 5 facility residents. Staff 1 stated there is someone a the front desk at all times until 7pm daily. Staff 1 stated any person that enters the building has to be let in by the front desk staff who pushes a button to open the front door. Staff 1 stated after 7pm the door is locked and anyone entering has to push a button from outside and wait for facility staff to allow them in. Staff 1 stated during the year she has worked there she has never seen anyone attempt to enter the building for the purpose of harming residents in the facility.
Continued on 9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Sarah Hurt	TELEPHONE: (916) 879-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2022

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

Control Number 27-AS-20220216165315

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: BROOKDALE TRACY	FACILITY NUMBER: 397003261
	VISIT DATE: 04/29/2022

NARRATIVE

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Administrator Sara Mackedsy stated the facility has added lighting to the front of the building to help residents feel safer at night around the building and the staff is trained on how to handle different situations if there is a safety issue in or around the building. LPA interviewed 5 facility residents and all besides one resident stated they have no issues at all with safety inside the building. LPA reviewed Tracy Police Department calls for service records dating back more than a year. The records reflected 24 calls to Tracy Police in over a year period none of the calls were related to resident or staff safety. Therefore, this complaint is UNSUBSTANTIATED. A finding that a 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.

Regarding the allegation Facility is short staffed. Based on LPA interviews and records reviewed the facility is not short staffed. LPA interviewed 5 facility residents and a majority stated they feel their needs are being met by facility staff. Administrator Sara Mackedsy stated the facility does have some staff calls outs from time to time they are overall not short staffed. Administrator Sara Mackedsy also stated she has plans in place like $250 bonus incentives for any staff willing to cover shifts if they are short staffed. The facility has 2 medication technicians, and 4 caregivers on the morning shift. The facility also has a health screener in the mornings. The facility has 2 medication technicians, and 4 caregivers in the evening. The facility has one medication technician, and 3 caregivers on overnight shift. Therefore, this complaint is UNSUBSTANTIATED. A finding that a 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.

Regarding the allegation Staff are unprofessional. Based on LPA interviews the staff is not unprofessional. LPA interviewed 5 residents and all besides one stated they really like the staff. The residents stated the staff does their best to meet all their needs and even in some cases going above and beyond for them. Therefore, this complaint is UNSUBSTANTIATED. A finding that a 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.

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Sarah Hurt	TELEPHONE: (916) 879-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 27-AS-20220216165315

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: BROOKDALE TRACY	FACILITY NUMBER: 397003261
	VISIT DATE: 04/29/2022

NARRATIVE

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Regarding the allegation Facility serves food that is not of good quality. Based on LPA interviews the facility food is of good quality. LPA interviewed 5 facility residents and 1 facility kitchen staff. Three of the residents interviewed stated they liked the food. One facility resident stated he does not feel the food is of good quality and is not served to them timely, and one resident stated she mostly likes it. LPA spoke with Kitchen staff 1 who stated everything she makes is from scratch and always listens to the residents when they have complaints or suggestions. Kitchen staff 1 stated she has meetings with the residents where they can bring up any issues they have with the food and she writes it down and takes each one serious Kitchen staff 1 stated she will make special requests for residents and wants them to be happy with the food quality. Therefore, this complaint is UNSUBSTANTIATED. A finding that a 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.

Regarding the allegation facility pendants do not work properly. Based on LPA interviews and records reviewed the facility pendants do work properly. LPA spoke with facility maintenance director who stated he tests ten random areas of the building weekly to ensure the pendants are working properly. The facility maintenance director stated during the tests staff actually responds and comes to the area where they are testing and on average it takes staff five to ten minutes to come to the area. The facility maintenance director stated despite the pendants not being brand new they do work. LPA reviewed the pendant testing documents and it reflects all pendants and pul chords passed the testing. Therefore, this complaint is UNSUBSTANTIATED. A finding that a 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. An exit interview was conducted with Business Services Coordinator Christina Goforth and a copy of this report was left at the facility.

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Sarah Hurt	TELEPHONE: (916) 879-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2022

LIC9099 (FAS) - (06/04)

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