502700444-11-13-2024-27-AS-KHOS-DAYRP8-20241113121131

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 502700444
Report Date: 11/07/2024
Date Signed: 11/13/2024 11:06:03 AM

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
07/10/2024 and conducted by Evaluator Arielle Pascua

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20240710151805

FACILITY NAME:	BETHEL ASSISTED LIVING		FACILITY NUMBER:	502700444
ADMINISTRATOR:	MELISSA ORELLO		FACILITY TYPE:	740
ADDRESS:	2325 & 2345 SCENIC DR		TELEPHONE:	(209) 577-1901
CITY:	MODESTO	STATE: CA	ZIP CODE:	95355
CAPACITY:	125	CENSUS: 108	DATE:	11/07/2024
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Maria Castillo Padilla		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Staff not following resident’s dietary needs.
Staff not serving meals in a timely manner.
Staff refuses to provide resident snack.

INVESTIGATION FINDINGS:

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On 11/07/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct a complaint visit. LPA met with Facility Designated Representative (FDR), Maria Castillo-Padilla and explained the purpose of the visit. The purpose of this visit was to deliver complaint findings for the allegations above.

Current Census was 108. A brief interview with FDR Padilla was conducted.
Allegation: Staff not following resident’s dietary needs.
It was alleged that the facility staff are not following resident’s dietary needs. During the course of this investigation LPA reviewed facility records and conducted interviews with staff and residents. Based on interviews conducted it was learned that this resident was currently on a special diabetic diet due to their diabetic diagnosis. It was learned that that facility had a care conference meeting to discuss some issues regarding the resident’s health. It was discussed that the facility would provide the resident with healthier snack options were brought to the resident’s room.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Arielle Pascua	TELEPHONE: (916) 862-5907
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024

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-20240710151805

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: BETHEL ASSISTED LIVING	FACILITY NUMBER: 502700444
	VISIT DATE: 11/07/2024

NARRATIVE

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In addition, it was learned that along with snacks, the facility provides a diabetic or low salt meals 3 times a day. Facility staff deny that the facility does not follow the resident’s dietary needs. An interview with the resident was conducted and it was learned that this resident does obtain snacks and meals however, they may be not what they would prefer to eat. In addition, a review of the residents care plan was conducted which confirmed that the facility is providing the resident their dietary needs. Based on the information gathered, it is unclear if the facility staff is not following resident’s dietary needs.
Allegation: Staff not serving meals in a timely manner.

It was alleged that the facility staff are not serving meals in a timely manner. During the course of this investigation, LPA conducted facility observations and conducted staff and resident interviews. An interview with 5 staff members was conducted. 5 out 5 staff members deny that they do not serve meals in a timely manner. 5 out 5 staff members state they some days they may be a couple minutes running late but meals can still be served hot to the residents in their rooms or in the dining room. An interview with 7 residents were conducted. 6 out 7 residents state that they get their meals within a reasonable time frame. 1 out 7 residents state that they do not get their meal in a timely manner. LPA observed lunch being served between the hours of 11:30am-1:30pm on 07/14/2024 and did not observe any indication that meals were not being served in a timely manner. Based on the information gathered, it is unclear if the facility staff are not serving meals in a timely manner.

Allegation: Staff refuses to provide resident snacks.

It was alleged that the staff refuses to provide resident snacks. During the course of this investigation, LPA conducted facility observations and conducted staff and resident interviews. Based on interviews conducted, 6 out 6 staff deny not providing residents with snacks. 6 out 6 staff state that they have enough food supply at this time to feed the residents. 6 out 6 staff members state that they are aware of where the snacks are if the kitchen would be locked and inaccessible. LPA conducted 9 resident interviews. out of 9 residents state that they do not get snacks or do not like the snacks provided. 6 out 9 residents state that they are able to have snacks throughout the day. Based on facility observations, LPA observed both perishable and non-perishable snacks in the kitchen that included but were not limited to, fresh fruits and vegetables, nature bars, fruit bar, and sandwiches. It was also observed that resident’s also obtained supply of snacks if requested to their bedrooms. Based on the observations, it is unclear if the facility staff refuse to provide resident snacks.

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Arielle Pascua	TELEPHONE: (916) 862-5907
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024

LIC9099 (FAS) - (06/04)

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Control Number 27-AS-20240710151805

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: BETHEL ASSISTED LIVING	FACILITY NUMBER: 502700444
	VISIT DATE: 11/07/2024

NARRATIVE

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As a result of this investigation, this Department found the allegations to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegations may have happened or was valid, there was not a preponderance of the evidence to prove that the alleged violation occurred.

There were no deficiencies observed or cited at this time. An exit interview was conducted, a copy of the 9099 and 9099-C was provided to the facility.

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Arielle Pascua	TELEPHONE: (916) 862-5907
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024

LIC9099 (FAS) - (06/04)

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