515002765-4-24-2024-59-AS-TORZ-D52PF4-20240507111606

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 515002765
Report Date: 04/24/2024
Date Signed: 04/24/2024 02:34:24 PM

Unsubstantiated

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
01/24/2024 and conducted by Evaluator Todd Tryon

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20240124122555

FACILITY NAME:	EMERALD OAKS		FACILITY NUMBER:	515002765
ADMINISTRATOR:	BAINS, GURPRIT		FACILITY TYPE:	740
ADDRESS:	2290 FORREST LANE		TELEPHONE:	(530) 490-1401
CITY:	YUBA CITY	STATE: CA	ZIP CODE:	95993
CAPACITY:	116	CENSUS: 67	DATE:	04/24/2024
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Ivy Garner, Assistant Adminstator		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff mistreating residents.

INVESTIGATION FINDINGS:

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On 4/24/2024 LPA Tryon went to the facility to complete the complaint. LPA met with Assistant Administrator Ivy Garner LPA has spoken with residents, staff, reviewed documentation.
Regarding the allegation that staff are mistreating residents, LPA has interviewed staff involved with the incident mentioned in the complaint, spoke with residents involved and briefly with other residents.
At this time, there is no proof that the staff actually mistreated the residents involved. One resident did fall when staff tried to open the bedroom door, but it's not completely clear if staff pushed the door hard enough to push the resident; or if she just lost her balance and fell. Stories related by staff differ from story related by residents involved. LPA has spoken with other residents and they have not seen any staff mistreat other residents or themselves, and related that staff is helpful and respectful.
At this time, since stories differ from one witness to another, LPA is not able to say with certainty that staff in any way "mistreated" residents. Therefore, LPA finds the allegation to be "unsubstantiated." A finding of unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the violation occurred.

Unsubstantiated

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: 04/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024

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 2

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
01/24/2024 and conducted by Evaluator Todd Tryon

COMPLAINT CONTROL NUMBER: 59-AS-20240124122555

FACILITY NAME:	EMERALD OAKS		FACILITY NUMBER:	515002765
ADMINISTRATOR:	BAINS, GURPRIT		FACILITY TYPE:	740
ADDRESS:	2290 FORREST LANE		TELEPHONE:	(530) 490-1401
CITY:	YUBA CITY	STATE: CA	ZIP CODE:	95993
CAPACITY:	116	CENSUS: 67	DATE:	04/24/2024
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Ivy Garner, Assistant Adminstator		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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9

Residents not allowed to use phone.

INVESTIGATION FINDINGS:

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During the course of the investigation LPA has spoken with residents involved, with other residents, and with staff. LPA learned that there are telephones on the wall in the hallways that are for resident use. Residents are allowed to use them to make calls. LPA learned that no one has ever told a resident they can't use the telephone. LPA learned from staff that It has been explained to certain residents that if they make repeated 911 calls without real need to do so, that it may effect the response they get from emergency personnel and could have negative consequences toward them or others in the facility by emergency responders, but no one was ever told they can't make calls. Therefore, the allegation is UNFOUNDED. An outcome of unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

No deficiencies were cited at this visit. Exit interview conducted, appeal rights provided,.

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: 04/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 2