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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 507000306
Report Date: 05/02/2024
Date Signed: 05/31/2024 10:43:11 AM

Unfounded


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
04/26/2024 and conducted by Evaluator Renee Campbell
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20240426093746
FACILITY NAME:COVENANT CARE-TURLOCK RESIDENTIALFACILITY NUMBER:
507000306
ADMINISTRATOR:RUTH VILLARREALFACILITY TYPE:
740
ADDRESS:1101 E. TUOLUMNE ROADTELEPHONE:
(209) 667-8409
CITY:TURLOCKSTATE: CAZIP CODE:
95380
CAPACITY:49CENSUS: 44DATE:
05/02/2024
UNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Executive Director Jennifer WarkentinTIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff did not provide adequate care and supervision to a resident.
Facility staff did not seek timely medical attention for a resident.
Facility staff did not communicate with authorized representative.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
A visit was conducted on 05/31/24 with Jennifer Warkentin, Executive Director, to amend the document from the 05/02/24 visit.

Licensing Program Analyst (LPA) Renee Campbell arrived on 05/02/24 to Covenant Care Turlock Residential to open a complaint for the above allegations. LPA Campbell met with Executive Director Jennifer Warkentin of Turlock Residential and Cheryl Rice, Executive Director of Turlock Nursing and Rehabilitation Center. After a review of the complaint allegations, it was found that R1 had been a patient at Turlock Nursing and Rehabilitation Center and not at Covenant Care Turlock Residential. The department therefore, has found that the complaint is unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Renee CampbellTELEPHONE: (916) 206-6380
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024
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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