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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 515000683
Report Date: 12/16/2022
Date Signed: 12/16/2022 12:27:14 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/22/2022 and conducted by Evaluator Kerry Hiratsuka
COMPLAINT CONTROL NUMBER: 25-AS-20220922101057
FACILITY NAME:COURTYARD, THEFACILITY NUMBER:
515000683
ADMINISTRATOR:PICKARD, CAROLFACILITY TYPE:
740
ADDRESS:1240 WILLIAMS WAYTELEPHONE:
(530) 790-3050
CITY:YUBA CITYSTATE: CAZIP CODE:
95991
CAPACITY:80CENSUS: 54DATE:
12/16/2022
UNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Carol PickardTIME COMPLETED:
12:35 PM
ALLEGATION(S):
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9
1. Staff are not properly trained to provide care and supervision
2. Staff leave the residents unattended while in care
3. Staff did not respond timely to the residents alerts
4. Staff are retaining residents who require a higher level of care
5. Resident was not provided comfortable accommodations
6. Staff are forcing the residents to sleep earlier while in care
INVESTIGATION FINDINGS:
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LPA Hiratsuka, conducted this unannounced complaint visit. LPA wore a surgical mask and observed wearing surgical masks.

LPA conducted the investigation into the allegations above.

LPA interviewed staff and residents. LPA reviewed training records and reviewed records for two residents no longer at this community.

1. LPA reviewed staff training records. The facility provides the training required by Community Care Licensing Division. LPA also observed the facility staff going over topics during all staff meetings and if someone needs extra training the facility provides it. Based on the records, the allegation is unfounded.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Kerry HiratsukaTELEPHONE: (916) 591-0210
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 25-AS-20220922101057
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: COURTYARD, THE
FACILITY NUMBER: 515000683
VISIT DATE: 12/16/2022
NARRATIVE
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2. Resident interviews stated they have no issues with staff not assisting them or not having any staff around. They stated there is always staff around. Staff interviews stated there is always staff around. Allegation is unfounded.

3. Residents have all stated there are no issues with staff not responding to call lights. LPA was informed there was an issue with resident call pendant batteries dying and not noticed for a very short period of time. LPA reviewed the call button log and observed some residents pushing a button within minutes of someone responding to the initial call button. Based on the above the allegation is unfounded.

4. Interviews indicate there are a couple of residents who are being monitored closely for changes in condition but otherwise no residents are beyond what the facility can provide. Allegation is unfounded.

5. Resident interviews state no living condition issues. Allegation is unfounded.

6. Resident interviews stated there are no issues with staff and are treated very well. Allegation is unfounded.

“This agency has investigated the complaint alleging; 1. Staff are not properly trained to provide care and supervision; 2. Staff leave the residents unattended while in care; 3. Staff did not respond timely to the residents alerts; 4. Staff are retaining residents who require a higher level of care; 5. Resident was not provided comfortable accommodations; 6. Staff are forcing the residents to sleep earlier while in care We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Kerry HiratsukaTELEPHONE: (916) 591-0210
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/22/2022 and conducted by Evaluator Kerry Hiratsuka
COMPLAINT CONTROL NUMBER: 25-AS-20220922101057

FACILITY NAME:COURTYARD, THEFACILITY NUMBER:
515000683
ADMINISTRATOR:PICKARD, CAROLFACILITY TYPE:
740
ADDRESS:1240 WILLIAMS WAYTELEPHONE:
(530) 790-3050
CITY:YUBA CITYSTATE: CAZIP CODE:
95991
CAPACITY:80CENSUS: 54DATE:
12/16/2022
UNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Carol PickardTIME COMPLETED:
12:35 PM
ALLEGATION(S):
1
2
3
4
5
6
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8
9
Resident was denied from using the restroom while in care
Resident was not afforded privacy while in care
Resident was left soiled while in care
Resident sustained a fall while in care
Staff did not seek timely medical attention for the residents
INVESTIGATION FINDINGS:
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2
3
4
5
6
7
8
9
10
11
12
13
LPA Hiratsuka, conducted this unannounced complaint visit. LPA wore a surgical mask and observed wearing surgical masks.

LPA conducted the investigation into the allegations above.

LPA interviewed staff and residents. LPA reviewed training records and reviewed records for two residents no longer at this community.

Because LPA was unable to interview the two former residents and not able to full interview a current resident LPA cannot prove or disprove the allegations above. The other interviews did not indicate any issues.

Based on the above the allegations are unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Kerry HiratsukaTELEPHONE: (916) 591-0210
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3