500306146-8-20-2021-27-AS-SDOB-C6WN3F-20210916100615

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 500306146
Report Date: 08/20/2021
Date Signed: 08/20/2021 03:07:02 PM

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
06/28/2021 and conducted by Evaluator Jason Lund

COMPLAINT CONTROL NUMBER: 27-AS-20210628092201

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:	DATE:	08/20/2021
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Administrator Kregg Miller		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Facility does not have Liability Insurance

INVESTIGATION FINDINGS:

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On 8/20/2021, Licensing Program Analyst (LPA) Jason Lund arrived at the facility unannounced to complete a complaint investigation regarding the above allegations. LPA Lund meet with Administrator Kregg Miller and explained the reason for the visit.

LPA Lund reviewed facility records interviewed staff and witnesses regarding the above allegation.

It was learned thorough interviews with the Adminisrtor Kregg Miller, that facility didn’t have Professional Liability Insurance since February 2020. The facility was attempting to get the Liability insurance and got Professional Liability Insurance on August 1, 2021.

As a result of this investigation, this LPA found the allegations to be SUBSTANTIATED - A finding that the complaint was Substantiated meant that the allegation was valid because the preponderance of the evidence standard had been met.

Substantiated

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: 08/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021

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 4

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
06/28/2021 and conducted by Evaluator Jason Lund

COMPLAINT CONTROL NUMBER: 27-AS-20210628092201

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:	DATE:	08/20/2021
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Administrator Kregg Miller		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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9

Facility is not responding to resident's representative's communications in a timely manner

INVESTIGATION FINDINGS:

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LPA Lund reviewed facility records interviewed staff and witnesses regarding the above allegation.
Based on interviews with staff, witness, and review of records. Valley Mountain Regional Center requested a copy of the facility Professional Liability Insurance it was learned through emails that the facility didn’t not have Professional Liability Insurance since February 2020.
It was learned thorough interviews, that Regional Center continued to ask for the Liability Insurance and didn’t get a response from the facility. The facility couldn’t respond back to Regional Center because they didn’t have Professional Liability Insurance until August 1, 2021.
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 Administrator Kregg Miller and a copy of report was left along with a copy of the appeal rights.

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: 08/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021

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

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 27-AS-20210628092201

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/20/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/02/2021 Section Cited HSC 1569.605	1 2 3 4 5 6 7	...all residential care facilities for the elderly...shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate...	1 2 3 4 5 6 7	Administrator got Professional Liability Insurance on 8/1/2021 through 8/1/2022
	8 9 10 11 12 13 14	This requirement is not met as evidenced by:Based on record review, the licensee failed to obtain and maintain current liability insurance. This poses a potential health, safety, and personal rights risk to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Jason Lund	TELEPHONE: (916) 223-6752
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021

LIC9099 (FAS) - (06/04)

Page: 4 of 4