500301453-7-19-2023-27-AS-KHOS-CU5KYU-20230727081943

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 500301453
Report Date: 07/19/2023
Date Signed: 07/19/2023 04:23:14 PM

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
03/13/2023 and conducted by Evaluator Jason Lund

COMPLAINT CONTROL NUMBER: 27-AS-20230313141319

FACILITY NAME:	COVENANT LIVING OF TURLOCK		FACILITY NUMBER:	500301453
ADMINISTRATOR:	RYAN HUST		FACILITY TYPE:	741
ADDRESS:	2125 N OLIVE AVENUE		TELEPHONE:	(209) 632-9976
CITY:	TURLOCK	STATE: CA	ZIP CODE:	95382
CAPACITY:	377	CENSUS: 34	DATE:	07/19/2023
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Director Melina Nunez		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Residents with Alzheimer's are allowed to dispense their own medication

Staff failed to provide a safe environment

Untrained staff

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to complete a complaint investigation. LPA met with Director Melina Nunez and explained the reason for today’s visit. Census 34
Staff failed to provide a safe environment- Based on records reviewed and interviews with staff and residents in care. Staff are properly trained on making sure residents in care are in a safe in the facility. Staff get initial training and biweekly training which helps keep the residents in a safe environment. Residents who wonder (Elope) the facility uses a wonder guard system to keep residents safe. Staff interviewed stated that there is enough staffing to meet the needs and services of the residents in care.

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Jason Lund	TELEPHONE: (916) 223-6752
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2023

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 2

Control Number 27-AS-20230313141319

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: COVENANT LIVING OF TURLOCK	FACILITY NUMBER: 500301453
	VISIT DATE: 07/19/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Based on facility records review, interviews with staff and residents the information provided, it was unclear if staff failed to provide a safe environment therefore the allegation was deemed UNSUBSTANTIATED.

Untrained staff- Based on records reviewed and interviews with staff and residents in care. Staff have a 40-hours or more orientation before going on the floor independently. Staff have training throughout their employment and have in services every two weeks. LPA Lund interviewed residents in care who felt the staff are well trained in the residents needs. Staff interviewed stated that there is enough staffing to meet the needs and services of the residents in care.

Based on facility records review, interviews with staff and residents the information provided, it was unclear if staff are untrained staff therefore the allegation was deemed UNSUBSTANTIATED.

Residents with Alzheimer's are allowed to dispense their own medication- Based on records reviewed and interviews conducted with staff and residents. The facility has three residents who dispense their own medications. All three residents LIC602 state that they can dispense their own medications. The facility does yearly Assisted Living Self-Administration of Medication Assessment to see if residents can continue to dispense their own medication. Staff interviewed has not seen any other residents dispense their own medication.

Based on facility records review, interviews with staff, clients, and RP the information provided, it was unclear if facility residents with Alzheimer's are allowed to dispense their own medication therefore the allegation was deemed UNSUBSTANTIATED.

The Department (CCLD) has found the allegations. Unsubstantiated.
A finding that the complaint allegation(s) are UNSUBSTANTIATED means that although the allegation(s) may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation(s) occurred.

An exit interview was conducted with Director Melina Nunez and report left

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Jason Lund	TELEPHONE: (916) 223-6752
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2