502701180-3-4-2024-27-AS-KHOS-D4DJB2-20240416065336

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 502701180
Report Date: 02/16/2024
Date Signed: 03/04/2024 01:07:05 PM

Substantiated

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
11/09/2023 and conducted by Evaluator Renee Campbell

COMPLAINT CONTROL NUMBER: 27-AS-20231109083759

FACILITY NAME:	COGIR OF TURLOCK		FACILITY NUMBER:	502701180
ADMINISTRATOR:	JOHNS, JANET		FACILITY TYPE:	740
ADDRESS:	3791 CROWELL ROAD		TELEPHONE:	(209) 664-9500
CITY:	TURLOCK	STATE: CA	ZIP CODE:	95382
CAPACITY:	100	CENSUS: 78	DATE:	02/16/2024
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Tony Montellano, Administrator		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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9

Staff did not provide resident's authorized representative with resident's records

INVESTIGATION FINDINGS:

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The allegation that staff did not provide residents authorized representatives with the resident’s records, has been found to be substantiated. During the initial complaint intake, it was stated that R1's MAR records were requested by resident representative after October of 2022. A document request via email on 10/18/23 and 10/25/23 came from a resident representative. In reply, Cogir stated in their October 25, 2023 email that they could not provide requested documents because they were archived with the prior owners of Cogir. All requested unredacted records were not received until 01/15/24 per a 01/15/24 email from the resident's representative.

The request for records in October of 2023 was not completed in full until February of 2024 instead of the 2 days as required. As a result of this investigation, this LPA found the allegation 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.Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, the following deficiency is being cited on the attached 809-D during this visit.
An exit interview was conducted, and copies of the report and appeal rights left.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Renee Campbell	TELEPHONE: (916) 206-6380
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2024

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-20231109083759

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: COGIR OF TURLOCK	FACILITY NUMBER: 502701180
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/16/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/25/2024 Section Cited CCR 87468.2(a)(19)	1 2 3 4 5 6 7	87468.2(a)(19) (19) To have prompt access to review all of their records and to purchase photocopies of their records. .. within two (2) business days and at a cost that does not exceed the community standard for photocopies. This standard has not been met as evidenced by:	1 2 3 4 5 6 7	The administrator will work with the licensee to establish a procedure to obtain documents for legacy residents currently residing in the facily by the POC date.
	8 9 10 11 12 13 14	-Based on observation, interviews and record review, it took the resident’s representative several months versus the two days required, to receive requested unredacted documents from the licensee which poses a potential Health, Safety or Personal Rights Risk.	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: Lisa Rios	TELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Renee Campbell	TELEPHONE: (916) 206-6380
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2024

LIC9099 (FAS) - (06/04)

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