515001963-5-20-2024-59-AS-TORZ-D5Q2Z8-20240528174953

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 515001963
Report Date: 05/20/2024
Date Signed: 05/20/2024 12:02:35 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH 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
01/30/2024 and conducted by Evaluator Todd Tryon

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20240130085226

FACILITY NAME:	WILLOW GLEN CARE CENTER		FACILITY NUMBER:	515001963
ADMINISTRATOR:	ANGIE KARIS		FACILITY TYPE:	740
ADDRESS:	1547 PLUMAS COURT		TELEPHONE:	(530) 751-9900
CITY:	YUBA CITY	STATE: CA	ZIP CODE:	95991
CAPACITY:	60	CENSUS: 59	DATE:	05/20/2024
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Angie Karis		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Staff is overmedicating resident in care.
Staff confiscated resident's inhaler.

INVESTIGATION FINDINGS:

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On 5/20/2024 LPA Tryon visited the facility to complete the complaint. LPA met with Angie Karis.
LPA has spoken with resident involved, has spoken with staff, reviewed medical and medication records.
Regarding the allegation that staff is overmedicating resident in care, through the team care process, it had been decided that an increase in one particular medication may be beneficial to the resident. Doctor had ordered an increase, and medication was given as prescribed by physician. By all accounts the resident was doing well, and the medication had obviously been effective. Since the medication was appropriately precribed through the team process, and medications were given as per order, LPA finds that the allegation that the staff is overmedicating resident is care is UNFOUNDED.
Regarding the allegation that the staff confiscated the resident's inhaler, it was learned that staff had informed the doctor that the resident had made a statement about misusing the medication; and therefore the doctor had discontinued it. Resident still had a regular inhaler, but it was a "rescue" inhaler that was discontinued. Resident stated that she felt the rescue inhaler was still needed; a follow-up doctor appointment was scheduled; and the doctor re-instated the medication. This took place in January 2024.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd Tryon	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2024

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 59-AS-20240130085226

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: WILLOW GLEN CARE CENTER	FACILITY NUMBER: 515001963
	VISIT DATE: 05/20/2024

NARRATIVE

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Therefore, the inhaler was not "confiscated" by the staff, but rather discontinued by the doctor; staff was following doctor orders. When the resident complained that she was having issues breathing, a doctor appointment was scheduled and it was re-instated. Therefore, the allegation is UNFOUNDED.

A finding that an allegation is UNFOUNDED means that the allegation is false, could not have happened, and/or is without a reasonable basis.

No deficiencies are cited at this visit. Exit interview conducted.

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd Tryon	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2024

LIC9099 (FAS) - (06/04)

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