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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 052700992
Report Date: 08/04/2023
Date Signed: 08/04/2023 12:07:01 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO AC/SC, 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
04/20/2023 and conducted by Evaluator Kimberly Viarella
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20230420150500
FACILITY NAME:FOOTHILL VILLAGE SENIOR LIVINGFACILITY NUMBER:
052700992
ADMINISTRATOR:BITLER, MAUREEN H.FACILITY TYPE:
740
ADDRESS:1400 FOOTHILL VILLAGE DRIVETELEPHONE:
(805) 801-0404
CITY:ANGELS CAMPSTATE: CAZIP CODE:
95222
CAPACITY:78CENSUS: DATE:
08/04/2023
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Angelica White, Resident Care DirectorTIME COMPLETED:
11:26 AM
ALLEGATION(S):
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Facility staff are not communicating with family in a timely manner.
Resident not being treated with dignity and respect by staff members.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kimberly Viarella made an unannouonced visit to this facility to deliver the findings of a complaint investigation. LPA met with Angelica White, the Resident Care DIrector, and explained the purpose of the visit.

With regard to the first allegation, "Facility staff are not communicating with family in a timely manner," based on information gathered throguh a records review and interviews during the course of this investigation, this Department found the allegations to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegations may have happened or were valid, there was not a preponderance of the evidence to prove that the alleged violation occurred. The facility was in communication with the family member designated with the medical and financial power of attorney and was not obligated to communicate with other members unless directed to do so.

The second allegation, "Resident not being treated with dignity and respect by staff members," was also
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023
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
Control Number 27-AS-20230420150500
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO AC/SC, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: FOOTHILL VILLAGE SENIOR LIVING
FACILITY NUMBER: 052700992
VISIT DATE: 08/04/2023
NARRATIVE
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found to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegations may have happened or were valid, there was not a preponderance of the evidence to prove that the alleged violation occurred. Theis LPA witnessed the resident interacting with staff and the representative of this Department in a manner that indicated the resident was comfortable (not fearful) and friendly. The resident smiled, conversed, and was provided the opportunity to share any concerns. It was learned during the interview process that the resident was not happy about complying with the new limitations brought about by their transition into the memory care area of the facility. There were incidents when the resident did not comply and difficult conversations took place regarding whether Foothill Village could meet the resident's needs. Although these conversations may have been uncomfortable for those involved, they were not disrespectful.

There were no deficiencies observed or cited during this visit.

Exit interview.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2