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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455002818
Report Date: 01/03/2024
Date Signed: 01/03/2024 09:41:16 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
11/13/2023 and conducted by Evaluator Donna Gurriere
COMPLAINT CONTROL NUMBER: 59-AS-20231113093620
FACILITY NAME:MERAKEY - OLD 44FACILITY NUMBER:
455002818
ADMINISTRATOR:PLUNKETT, WILLIAMFACILITY TYPE:
738
ADDRESS:21345 OLD 44 ROADTELEPHONE:
(530) 768-7336
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY:4CENSUS: 3DATE:
01/03/2024
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:ZEKE CONTRERASTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Staff did not treat a resident with dignity and respect.
INVESTIGATION FINDINGS:
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On 01/03/24 Donna Gurriere, Licensing Program Analyst (LPA) arrived at the facility unannounced to deliver final findings regarding a complaint that was received on 08/22/23. LPA Gurriere met with Zeke Contreras, Administrator, and explained the purpose of the visit.

Staff did not treat a resident with dignity and respect.

During the interview process, the people that were involved with the incident were interviewed. In addition, the regional center manager was interviewed. The resident (Resident 1) was not interviewed, as he was not aware of the incident that occurred. Documents were received and reviewed to include the Physician’s Report, Admissions Agreement, the resident’s Individual Program Plan (IPP), and Individual Behavior Support Plan (IBSB).

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

DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2024
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 59-AS-20231113093620
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: MERAKEY - OLD 44
FACILITY NUMBER: 455002818
VISIT DATE: 01/03/2024
NARRATIVE
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During the investigation process, it was reported that staff are to check on the resident every 15 minutes, even when sleeping, as the resident is prone to seizures. It was stated that a staff person turned the resident’s bedroom light on and off a few times to see if the resident was sleeping or if there was any type of seizure concern. It was reported that the resident slept through the incident. It was stated that no one felt that the staff person was intentionally trying to hurt the resident. It was also indicated that no one was aware that turning the lights on and off could trigger a seizure.


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

DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2