<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 502700235
Report Date: 11/21/2024
Date Signed: 11/21/2024 04:25:11 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
08/16/2024 and conducted by Evaluator Maja Jensen
COMPLAINT CONTROL NUMBER: 27-AS-20240816145258
FACILITY NAME:EL RIO MEMORY CARE COMMUNITYFACILITY NUMBER:
502700235
ADMINISTRATOR:THERESA PETTAPIECEFACILITY TYPE:
740
ADDRESS:2828 HEALTHCARE WAYTELEPHONE:
(209) 543-3805
CITY:MODESTOSTATE: CAZIP CODE:
95356
CAPACITY:72CENSUS: DATE:
11/21/2024
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:TIME COMPLETED:
04:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not ensure that resident had eaten breakfast in a timely manner
Residents are being neglected
Staff did not provide a comfortable environment for residents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/21/24 Licensing Program Analyst (LPA) Maja Jensen arrived at facility unannounced to continue a compliant investigation in to the above listed allegations. LPA Jensen met with Executive Director Theresa Pettapiece and explained the purpose of today's visit.

During the course of the investigation LPA Jensen inspected the facility on 3 separate occassions. LPA Jensen also interviewed 6 staff members, 4 residents and 1 family member of a resident.

Allegation 1: Staff did not ensure that resident had eaten breakfast in a timely manner
LPA Jensen spoke to residents, family, care staff, and kitchen staff. All parties interviewed denied having any issues with getting meals on time therefore the allegation is UNSUBSTANTIATED. A finding of unsubstantiated means that although the allegation may have happened, the preponderance of evidence does not prove it.
Contiued on LIC 9099C....

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
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 27-AS-20240816145258
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: EL RIO MEMORY CARE COMMUNITY
FACILITY NUMBER: 502700235
VISIT DATE: 11/21/2024
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
Allegation 2: Residents are being neglected
LPA Jensen interviewed staff members, residents and a family member. All parties interviewed denied having any concerns regarding the care they are receiving. LPA Jensen also toured the facility on 3 separate occasions and did not observe any evidence of neglect. The facility appeared to be appropriately staffed on all 3 occasions. LPA Jensen did observe 1 resident that was in need of incontinence care on one occasion and 3 residents in need of incontinence care on another occasion but these observations do not appear to rise to the level of neglect therefore the allegation is UNSUBSTANTIATED. A finding of unsubstantiated means that although the allegation may have happened, the preponderance of evidence does not prove it.

Allegation 3: Staff did not provide a comfortable environment for residents
LPA Jensen inspected the facility on 3 separate occasions and on all occasions a comfortable and sanitary environment was observed. LPA Jensen also interviewed 4 clients and a family member, none of whom had any negative comments about their environment therefore the allegation is UNSUBSTANTIATED. A finding of unsubstantiated means that although the allegation may have happened, the preponderance of evidence does not prove it.

Technical assistance was provided on managed incontinence.

No deficiencies are being cited. An exit interview was conducted. A copy of this report and appeal rights were provided.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2