500306146-12-22-2022-27-AS-KHOS-CNGJJY-20230127060618

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 500306146
Report Date: 12/22/2022
Date Signed: 12/22/2022 03:24:56 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
09/16/2022 and conducted by Evaluator Jason Lund

COMPLAINT CONTROL NUMBER: 27-AS-20220916131407

FACILITY NAME:	LAS PALMAS ESTATES		FACILITY NUMBER:	500306146
ADMINISTRATOR:	MILLER, KREGG		FACILITY TYPE:	740
ADDRESS:	1617 COLORADO		TELEPHONE:	(209) 632-8841
CITY:	TURLOCK	STATE: CA	ZIP CODE:	95382
CAPACITY:	89	CENSUS: 85	DATE:	12/22/2022
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Le Ann Blocker Resident Coordinator		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Resident's hygiene needs are not being met

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jason Lund arrived at the above facility unannounced to complete a complaint investigation regarding the above allegation. LPA Lund Le Ann Blocker Resident Coordinator and explained the reason for the visit.

Resident's hygiene needs are not being met- Based on interviews with staff, residents, witness and Resident (R1). Facility records LIC602 for R1 dated 7/7/2022 indicates that R1 able to bath self with marginal self-care. Staff stated that they direct R1 to take showers on a daily basis. R1 will refuse to take showers sometimes but staff come back to R1 at a later time and R1 will take a shower. R1 wears a prosthesis and get help with staff to make sure get proper care and supervision that R1 needs. LPA Lund observed R1’s prosthesis and looked that R1 was getting proper care and supervision.

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: 12/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 27-AS-20220916131407

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: LAS PALMAS ESTATES	FACILITY NUMBER: 500306146
	VISIT DATE: 12/22/2022

NARRATIVE

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Based facility records review, interviews with staff, witness and R1 on the information provided, it was unclear if resident's hygiene needs are not being met therefore the allegation was deemed UNSUBSTANTIATED.

As a result of this investigation, this Department finds the allegation to be UNSUBSTANTIATED. A complaint allegation finding of 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 occurred.

Exit interview was conducted with Le Ann Blocker Resident Coordinator and a copy of report was left.

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Jason Lund	TELEPHONE: (916) 223-6752
LICENSING EVALUATOR SIGNATURE:	DATE: 12/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2022

LIC9099 (FAS) - (06/04)

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