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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 045002696
Report Date: 04/15/2025
Date Signed: 04/15/2025 09:57:46 AM

Substantiated


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
02/27/2025 and conducted by Evaluator Donna Gurriere
COMPLAINT CONTROL NUMBER: 59-AS-20250227121436
FACILITY NAME:TOWNSEND HOUSEFACILITY NUMBER:
045002696
ADMINISTRATOR:PASQUALE, CHABLISFACILITY TYPE:
740
ADDRESS:10 ILAHEE LNTELEPHONE:
(530) 342-4455
CITY:CHICOSTATE: CAZIP CODE:
95973
CAPACITY:38CENSUS: 35DATE:
04/15/2025
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:ANTOYA LEETIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Personal Rights - Staff did not treat resident with dignity or respect.
INVESTIGATION FINDINGS:
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On 04/15/25 Donna Gurriere arrived at the facility unannounced to deliver final findings regarding a complaint that was received on 02/27/25. LPA Gurriere met with Antoya Lee, Administrator Assistant and explained the purpose of the visit.

Personal Rights - Staff did not treat resident with dignity or respect.

During the interview process, the administrator, and eight staff persons were interviewed. Documents were obtained to include Physicians Reports, Emergency Information, Appraisals and Needs and Admission Agreements, Incident Reports, Medical Administrative Records (MARs), staff persons names and contact numbers.

During the investigation, it was reported that a staff person violated a resident’s (Resident 1) personal rights when the staff person videoed the resident in the bathroom on the toilet. Staff person was terminated.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Donna Gurriere
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2025
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 59-AS-20250227121436
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: TOWNSEND HOUSE
FACILITY NUMBER: 045002696
VISIT DATE: 04/15/2025
NARRATIVE
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Based on investigation observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, (Title 22), is cited on the attached LIC 9099D.

Appeal Rights provided.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Donna Gurriere
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 59-AS-20250227121436
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: TOWNSEND HOUSE
FACILITY NUMBER: 045002696
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/15/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/16/2025
Section Cited
CCR
87468.1(a)(1)
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Personal Rights of Residents in All Facilities - Residents in all residential care facilities for the elderly shall have all of the following personal rights: To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination.
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The administrator agrees to provide training to all staff regarding the personal rights of residents residing in a facility.
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This requirement was not met as evidenced by: Based on interviews the licensee/ administrator did not protect the personal rights of a resident when a video took place while the resident was on the toilet. This poses an immediate 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.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Donna Gurriere
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3