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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 496803639
Report Date: 08/22/2024
Date Signed: 08/22/2024 03:18:15 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/18/2024 and conducted by Evaluator Christi Coppo
COMPLAINT CONTROL NUMBER: 21-AS-20240618094648
FACILITY NAME:PEOPLE'S CARE CHARMIANFACILITY NUMBER:
496803639
ADMINISTRATOR:SEAWRIGHT, PATRICKFACILITY TYPE:
740
ADDRESS:5087 CHARMIAN DRTELEPHONE:
(707) 537-9795
CITY:SANTA ROSASTATE: CAZIP CODE:
95409
CAPACITY:4CENSUS: DATE:
08/22/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Patrick Seawright, AdministratorTIME COMPLETED:
03:32 PM
ALLEGATION(S):
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Resident's needs are not being met
Personal Rights
Facility staff do not have required First Aid and/or CPR certification
Facility does not provide activites
Facility is not following doctor's orders
INVESTIGATION FINDINGS:
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At approximately 3:00pm, Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to deliver findings regarding the above allegations and met with Patrick Seawright, Administrator.

Complaint alleges resident's needs are not being met. RP states that resident is being fed according to another resident’s care plan. During investigation LPA reviewed facility’s meal plan for resident and physician’s report. Per the resident’s physician report, no special diet is required. Per the resident’s Individual Service Plan (ISP) they are to have a mechanical soft diet. Facility has a detailed Daily Routine Cheat Sheet for the resident which outlines very specific foods and mealtime instructions for staff as well as also identifying their care needs that should be attended to each day. LPA finds that daily routine cheat sheet is comprehensive. Facility provided meal meus that are comprehensive and include a wide variety of foods and snacks.

Continued on 9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Christi Coppo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
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 3
Control Number 21-AS-20240618094648
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: PEOPLE'S CARE CHARMIAN
FACILITY NUMBER: 496803639
VISIT DATE: 08/22/2024
NARRATIVE
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continued from 9099...

During LPA investigative visit, as well as previous visits, LPA observed staff preparing resident’s meal according to resident’s specific dietary needs as outlined in their ISP. Additionally, complaint alleges resident’s legs not being elevated per their care plan because their hospital bed was broken. Investigation revealed that bed’s foot raising feature was broken for approximately one week. However, the primary way by which resident’s legs were elevated is by use of wedges and pillows. The bed being broken did not prohibit resident’s legs from being elevated as the foot raising feature was used as a supplemental aid to help raise and elevate the legs; it was not the main source of elevation. So, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Complaint alleges Personal Rights. RP states that resident postural support chair (recliner) was not implemented timely by facility which resulted in resident not being able to be in common areas of facility. During investigation, LPA reviewed doctor’s orders and there is no mention of a postural support chair being needed. Resident’s wound care doctor noted that the legs being elevated would be good but did not specify the method by which the legs should be elevated. Investigation revealed that request was made by resident’s POA for a postural support chair in beginning in March. Per LPA interviews, POA wanted the recliner placed in a certain area of the home, in order to accommodate the request, facility needed to stabilize the base of the recliner and made the request to do so with a handyman. On April 18, 2024 facility added the use of a recliner to resident’s care plan. On April 30, 2024 LPA received a request inquiry from facility in regards to the use of a recliner for resident as a postural support chair. LPA and facility discussed maintaining compliance with regulations as pertains to implementing the recliner as part of resident’s care plan. On May 7, 2024 LPA gave the okay for use of the recliner. Per LPA investigation facility addressed recliner request and made the required notifications and requests to licensing within a span of 60 days. The absence of the recliner chair cannot confirm that resident that resident was isolated due to lack of chair. So, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.



Continued on 9099C(2)...
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Christi Coppo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 21-AS-20240618094648
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: PEOPLE'S CARE CHARMIAN
FACILITY NUMBER: 496803639
VISIT DATE: 08/22/2024
NARRATIVE
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Continued from 9099C(2)...

Complaint alleges Facility staff do not have required First Aid and/or CPR certification. During investigation LPA observed one staff member to not have 1st Aid/CPR training. However, this staff was just recently hired and only ever was scheduled to work with another staff member present at all times. All other staff have current 1st Aid/CPR. Per Health and Safety Code 1569.618(c)(3), the facility shall employ at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. So, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Complaint alleges Facility does not provide activities. During investigation LPA observed residents participating in activities. During LPA annual inspection in 2023 and all subsequent visits to the facility in 2024, each time LPA was present at the facility, LPA has observed residents participating in activities. Facility has a readily visible large assortment of games, puzzles, and a wide and varying amount of art supplies available, all of which are stored in front living room. So, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Complaint alleges Facility is not following doctor's orders. During investigation LPA reviewed doctor’s care notes for resident. Per LPA review of resident’s Individual Service Plan (ISP), current list of doctor’s orders, care notes, and doctor visit summary, facility is following doctor’s orders. Resident’s Daily Routine Cheat Sheet is in line with doctor’s orders, physician’s report, and ISP. Doctor notes wound care is adequate as wound is almost completely healed. Facility In-Service training records show staff training on resident’s specialized equipment and for resident’s wound care. Complainant indicates resident losing weight due to possible neglect. Investigative review of doctor visit summary indicates despite adequate caloric intake, resident is still losing weight. Doctor has referred resident to specialty department for further testing. So, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

No deficiencies cited.
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Christi Coppo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3