507005604-6-4-2021-27-AS-SDOB-C3USWA-20210610141401

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 507005604
Report Date: 06/02/2021
Date Signed: 06/04/2021 07:38:22 AM

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
05/24/2021 and conducted by Evaluator Sarah Hurt

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20210524092658

FACILITY NAME:	ASTORIA AT OAKDALE		FACILITY NUMBER:	507005604
ADMINISTRATOR:	LETICIA HIGARES		FACILITY TYPE:	740
ADDRESS:	700 LAUREL AVE		TELEPHONE:	(209) 847-0864
CITY:	OAKDALE	STATE: CA	ZIP CODE:	95361
CAPACITY:	45	CENSUS: 34	DATE:	06/02/2021
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	ADMINISTRATOR - LETICIA HIGARES		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Facility has not provided appropriate living accommodations for resident.
Resident is not free from humiliation.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA'S) Ruth Wallace and Sarah Hurt conducted a complaint investigation. LPA followed all COVID-19 and pre-cautionary measures. LPA's identified themselves and discussed the purpose of the visit and the allegations with the Administrator.

Based on LPA's interview with Administrator and resident (R1), review of medical files, admission residence care plan, resident transfer room form, and social security awarded Medi-Cal benefits; LPA's did not find resident (R1's) living accommodations were inappropriate. Personal monies for facility monthly fee were exhausted several months ago. R1's previous room was at a higher rate and R1 was moved on 5/2/2021 to a studio in the memory care with bathroom. R1 does not have Dementia, but does need help with daily living activities and the shower is across the hall from new room. There is no evidence that the Facility has not provided appropriate living accommodations for resident. Therefore the allegation Facility has not provided appropriate living accommodations for resident is deemed UNFOUNDED. 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.

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: 06/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2021

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-20210524092658

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: ASTORIA AT OAKDALE	FACILITY NUMBER: 507005604
	VISIT DATE: 06/02/2021

NARRATIVE

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Continued from 9099 - Page 2

Based on LPA's interview with Administrator and resident (R1), review of medical records, admission residence care plan resident transfer room form; LPA's interview with R1 concluded that R1 is treated with dignity and respect. R1 appears to be sad that a move will transpire in the next several weeks. There is no evidence that resident has been humiliated. Therefore the allegation Resident is not free from humiliation is deemed UNFOUNDED. 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.

An exit interview was conducted with Administrator and a copy of this report LIC 9099, LIC 858- Client Records, LIC 811- Confidential Names, and Appeal Rights was provided to the Administrator via email and an electronic email read receipt confirms receiving these documents. Administrator will send 9099 and 9099-C back via email signed to LPA Hurt.

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Sarah Hurt	TELEPHONE: (916) 879-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2021

LIC9099 (FAS) - (06/04)

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