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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455002759
Report Date: 02/27/2024
Date Signed: 02/27/2024 08:19:59 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH 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
12/12/2023 and conducted by Evaluator Donna Gurriere
COMPLAINT CONTROL NUMBER: 59-AS-20231212133635
FACILITY NAME:CRAFTSMAN HOUSE, INC.FACILITY NUMBER:
455002759
ADMINISTRATOR:OSTERMAN, DORISFACILITY TYPE:
735
ADDRESS:3716 CRAFTSMAN AVE.TELEPHONE:
(530) 605-4659
CITY:SHASTA LAKESTATE: CAZIP CODE:
96019
CAPACITY:6CENSUS: 3DATE:
02/27/2024
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:BRITTANY HENRYTIME COMPLETED:
08:35 AM
ALLEGATION(S):
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A resident is not receiving medical care.
A resident is not receiving dental care.
INVESTIGATION FINDINGS:
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On 02/27/24 Donna Gurriere, Licensing Program Analyst (LPA) arrived at the facility unannounced to deliver final findings regarding a complaint that was received on 12/12/23. LPA Gurriere met with Brittany Henry and explained the purpose of the visit.

A resident is not receiving medical care.

During the interview process, the licensee, the administrator, a staff person, and the resident (Resident 1) were interviewed. Documents were received and reviewed to include the Individual Program Plan (IPP), the admission agreement, medical and dental care records, and appointment records.



continued
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Donna Gurriere
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024
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 59-AS-20231212133635
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CRAFTSMAN HOUSE, INC.
FACILITY NUMBER: 455002759
VISIT DATE: 02/27/2024
NARRATIVE
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During the investigation the staff persons and the resident stated that the resident is currently providing a cream for her Rosacea on her face. The resident stated that she and the staff persons apply the prescribed cream twice a day. The resident had an appointment with the dermatologist on 11/02/23. Further documentation indicates that the resident has follow up appointments on 03/02/24 and on 03/25/24. The Resident is receiving medical care.

A resident is not receiving dental care.

During the interview process, the licensee, the administrator, a staff person, and the resident (Resident 1) were interviewed. Documents were received and reviewed to include the Individual Program Plan (IPP), the admission agreement, medical and dental care records, and appointment records/notes.

During the investigation the staff persons and the resident stated that although the resident does not have her natural teeth available, the resident does have dentures. The resident stated that she does not want to wear her dentures, as they make her “cough.” The resident stated that she is fine without her dentures and that staff cut up her food into small bites so that she can process and swallow. On 09/28/23, the dentist stated in the resident’s records “The patient said that she does not have any trouble eating. I explained to patient and caretaker that her dentures likely do not fit anymore and if she is functioning just fine without them, she doesn’t have to wear dentures.” The Resident is receiving dental care.

Although the above allegations mentioned may have happened, or is valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and all of the above findings are Unsubstantiated.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Donna Gurriere
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2