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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 552700409
Report Date: 07/13/2022
Date Signed: 07/15/2022 02:53:57 PM

Substantiated


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
07/13/2022 and conducted by Evaluator Sarah Hurt
COMPLAINT CONTROL NUMBER: 27-AS-20220713141635
FACILITY NAME:SONORA SENIOR LIVINGFACILITY NUMBER:
552700409
ADMINISTRATOR:MICHAEL MALONEYFACILITY TYPE:
740
ADDRESS:18760 CHABROULLIAN LNTELEPHONE:
(209) 984-5124
CITY:JAMESTOWNSTATE: CAZIP CODE:
95327
CAPACITY:90CENSUS: 60DATE:
07/13/2022
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Resident Care Coordinator, Maranda EscobedoTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Facility was holding residents money
Resident feels money is being taken from him by facility
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced facility visit on 07/13/2022 to investigate the above allegations. LPA met with Resident Care Coordinator Maranda Escobedo and explained the purpose of today's visit.

Regarding the allegation facility was holding residents money. Based on interviews, and records reviewed the facility was holding and tracking money for Resident 1. LPA observed an envelope with $100 bill inside and some change with a handwritten tracking log inside. Resident 1 stated former Administrator Michael Maloney was holding his money and giving it to him over time when he would ask for it. The facility does not have the proper bond issued by a surety company to the State of California as principal on file with Licensing. The facility should not be holding or tracking any resident monies. Therefore, this complaint is SUBSTANTIATED.

Continued on 9099C...
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Stephenie DoubTELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Sarah HurtTELEPHONE: (916) 879-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022
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 27-AS-20220713141635
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: SONORA SENIOR LIVING
FACILITY NUMBER: 552700409
VISIT DATE: 07/13/2022
NARRATIVE
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Continued from 9099...


Regarding the allegation resident feels money is being taken from him by facility. Based on records reviewed the amount of money former Administrator Michael Maloney documented inside the envelope containing Resident 1's money to begin with is $2,400. Administrator Michael Maloney upon leaving gave the envelope back to Resident 1 with $100.45 left inside. The tracking log inside the envelope reflects there should be more than $700 leftover. There is more than $600 unaccounted for from the envelope. Therefore, this complaint is SUBSTANTIATED.

The following deficiencies are being cited today Per Title 22 Regulations.

Exit interview conducted with Resident Care Coordinator Maranda Escobedo and a copy of this report left at the facility along with appeals rights provided.
SUPERVISOR'S NAME: Stephenie DoubTELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Sarah HurtTELEPHONE: (916) 879-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20220713141635
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: SONORA SENIOR LIVING
FACILITY NUMBER: 552700409
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/13/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/28/2022
Section Cited
CCR
87216(a)(1)
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87216 Bonding (a) Each licensee, other than a county, who is entrusted to safeguard resident cash resources, shall file or have on file with the licensing agency a copy of a bond issued by a surety company to the State of California as principal.(1) The amount of the bond shall be in accordance with the following schedule: The following requirement has not been evidenced by:
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Licensee will conduct staff training on resident finances and sumbit proof to LPA by 07/28/2022.
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Based on records reviewed the former Administrator Michael Maloney was holding and tracking money for Resident 1 which poses a potential, health, safety, or personal rights risk to residents in care.
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Type B
07/27/2022
Section Cited
CCR
87218(3)(a)
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87218 Theft and Loss (3) (a) The licensee shall ensure an adequate theft and loss program as specified in Health and Safety Code Section 1569.153. The following requirement has not been met as evidenced by:
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The Licensee shall replace the $600 unaccounted for and send proof to LPA by 07/27/2022 POC date.
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The former Administrator Michael Maloney did not properly track resident monies, and more than $600 is not accounted for which poses a potential health, safety, or personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Stephenie DoubTELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Sarah HurtTELEPHONE: (916) 879-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022
LIC9099 (FAS) - (06/04)
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