502700235-9-3-2021-27-AS-KHOS-C6NLBM-20210908083655

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 502700235
Report Date: 09/03/2021
Date Signed: 09/03/2021 12:52:06 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
07/28/2021 and conducted by Evaluator Sarah Hurt

COMPLAINT CONTROL NUMBER: 27-AS-20210728145900

FACILITY NAME:	EL RIO MEMORY CARE COMMUNITY		FACILITY NUMBER:	502700235
ADMINISTRATOR:	KEATON, MARY		FACILITY TYPE:	740
ADDRESS:	2828 HEALTHCARE WAY		TELEPHONE:	(209) 543-3805
CITY:	MODESTO	STATE: CA	ZIP CODE:	95356
CAPACITY:	72	CENSUS: 62	DATE:	09/03/2021
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Mary Keaton		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff denied resident from having visitors
Resident not awarded privacy
Staff denied resident a phone

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit to the facility on September 3, 2021 to deliver complaint findings. LPA identified herself and discussed the purpose of the visit with Administrator Mary Keaton.
This investigation consisted of interviews with facility Administrator, complainant, and resident. Also reviewing of the resident files and facility records, and legal documents related to this complaint.

Regarding the allegation that staff denied resident from having visitors. Based on LPA's interview with Administrator, complainant, and resident (R1), review of medical files, admission agreement, residence care plan, and temporary restraining order. It was determined that all persons not mentioned in the restraining order were still allowed to visit, call and have contact with resident. Only those mentioned in order were denied access to resident. This agency has investigated the allegation noted above and have found that the facility never denied residents from having visitors and this complaint is UNFOUNDED, meaning that the allegation was false, could not have happened and/or was without a reasonable basis. We have therefore, dismissed the complaint.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Sarah Hurt	TELEPHONE: (916) 879-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2021

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-20210728145900

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: EL RIO MEMORY CARE COMMUNITY	FACILITY NUMBER: 502700235
	VISIT DATE: 09/03/2021

NARRATIVE

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Regarding the allegation that resident was not awarded privacy. Based on interviews with complainant, administrator, and resident. It was determined that resident was never denied privacy. The facility allowed resident to have visitors in her room. This agency has investigated the allegation above and have found that the complaint is UNFOUNDED, meaning that the allegation was false, could not have happened and/or was without a reasonable basis. We have therefore, dismissed the complaint.

Regarding the allegation that staff denied resident a phone. LPA did not find facility violated R1’s rights to use the telephone. The facility was complying with a temporary restraining order put in place when they did limit R1’s calls. The Power of Attorney of R1, disconnected the cell phone of R1, but resident did have access to facility phone. This agency has investigated the allegation noted above and have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or was without a reasonable basis. We have therefore, dismissed the complaint.

Exit interview was conducted, and a copy of this report was left at the facility.

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Sarah Hurt	TELEPHONE: (916) 879-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2021

LIC9099 (FAS) - (06/04)

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