585000698-11-9-2020-25-AS-RLBN-BVAU8F-20201112142126

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 585000698
Report Date: 11/09/2020
Date Signed: 11/09/2020 10:44:44 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASETT RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/12/2020 and conducted by Evaluator Donna Gurriere

COMPLAINT CONTROL NUMBER: 25-AS-20200312154138

FACILITY NAME:	PRESTIGE ASSISTED LIVING AT MARYSVILLE		FACILITY NUMBER:	585000698
ADMINISTRATOR:	STRAHL, BRANDY		FACILITY TYPE:	740
ADDRESS:	515 HARRIS STREET		TELEPHONE:	(530) 749-1786
CITY:	MARYSVILLE	STATE: CA	ZIP CODE:	95901
CAPACITY:	72	CENSUS: 46	DATE:	11/09/2020
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	BRANDY STRAHL		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Care and Supervision – Staff persons leave residents in soiled diapers.
Physical Plant – Lift sling is not cleaned; however, is shared amongst multiple residents.
Care and Supervision – Staff persons provided limited amounts of water intake to residents.

INVESTIGATION FINDINGS:

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Donna Gurriere, Licensing Program Analyst (LPA) was in contact with Brandy Strahl, Administrator. A physical visit could not be made due to the orders in place regarding the Covid 19 Virus. The following was alleged: Care and Supervision – Staff persons leave residents in soiled diapers, Physical Plant – Lift sling is not cleaned; however, is shared amongst multiple residents and Care and Supervision – Staff persons provided limited amounts of water intake to residents.

The administrator, numerous staff persons (9) and residents were interviewed with the following outcome:

Care and Supervision – Staff persons leave residents in soiled diapers. During the interview process it was reported that staff check on residents every two hours and approximately 3-4 times per shift. It was reported that staff are conscience of keeping the residents clean and dry. Allegation is Unsubstantiated.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rayna L Bryson	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Donna Gurriere	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2020

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 25-AS-20200312154138

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASETT RD., STE. 170
CHICO, CA 95926

FACILITY NAME: PRESTIGE ASSISTED LIVING AT MARYSVILLE	FACILITY NUMBER: 585000698
	VISIT DATE: 11/09/2020

NARRATIVE

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Physical Plant – Lift sling is not cleaned; however, is shared amongst multiple residents. During the interview process, it was reported that the lift sling is cleaned frequently, is sanitized after each use with a bleach type substance and that each resident has their own sling. It was reported that additional slings are available for residents in case there is a need. Overall, it was reported that the lift sling is cleaned after each use. Allegation is Unsubstantiated.

Care and Supervision – Staff persons provided limited amounts of water intake to residents. During the interview process, it was reported that residents are offered water throughout the day, they are offered water and juice with each meal and with snacks and that there is a water dispenser in the memory care unit. Overall, it was reported that staff do provide the residents with water and juice throughout the day. Allegation is Unsubstantiated.

Based on the information obtained and interviews conducted, the above three allegations are Unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred and the findings are Unsubstantiated.

SUPERVISOR'S NAME: Rayna L Bryson	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Donna Gurriere	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2020

LIC9099 (FAS) - (06/04)

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