097005555-7-17-2024-59-AS-LMUZ-D85Q89-20240814115621

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 097005555
Report Date: 07/17/2024
Date Signed: 07/17/2024 03:15:42 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
04/23/2024 and conducted by Evaluator Lavinia Muscan

COMPLAINT CONTROL NUMBER: 59-AS-20240423110151

FACILITY NAME:	OAKRIDGE SENIOR CARE		FACILITY NUMBER:	097005555
ADMINISTRATOR:	DR. BENJAMIN FOULK		FACILITY TYPE:	740
ADDRESS:	2896 CENTERBURY CIRCLE		TELEPHONE:	(916) 933-0107
CITY:	EL DORADO HILLS	STATE: CA	ZIP CODE:	95762
CAPACITY:	6	CENSUS: 4	DATE:	07/17/2024
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	RCC Amanda Hinch		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff interfered with the resident's right to make decision about their care
Facility staff are not adequately trained to meet the needs of residents in care
Staff do not transfer resident in a safe manner
Staff do not have equipment required to meet residents needs

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 7/17/24, Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced to deliver complaint findings into the allegations listed above and met with RCC Amanda Hinch.

During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation.

The results of the investigation are as follows:

**Report continued on 9099-C**

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024

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 4

Control Number 59-AS-20240423110151

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: OAKRIDGE SENIOR CARE	FACILITY NUMBER: 097005555
	VISIT DATE: 07/17/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Staff interfered with the resident's right to make decision about their care
Through the course of the investigation process, CCL conducted interviews, toured the facility, and reviewed records regarding the allegation above. During the investigation, it was determined that after R1 asked to go to bed later, facility planned to have staff work a little later to accommodate resident desires. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation UNSUBSTATIATED.

Facility staff are not adequately trained to meet the needs of residents in care
Staff do not transfer resident in a safe manner
Staff do not have equipment required to meet residents needs
Through the course of the investigation process, CCL conducted interviews, toured the facility, and reviewed records regarding the allegations above. During the investigation, the department reviewed staff training records and observed that required training requirements were met, including how to safely transfer residents, and using required equipment for transfer. Staff interviewed indicated that staff have required mandated training. Though training requirements are met, meaning classes were taken; LPA cannot ascertain if all staff understood the training and applied it appropriately. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation UNSUBSTATIATED.

Exit interview conducted and copy of this report was left at the facility.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 4

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
04/23/2024 and conducted by Evaluator Lavinia Muscan

COMPLAINT CONTROL NUMBER: 59-AS-20240423110151

FACILITY NAME:	OAKRIDGE SENIOR CARE		FACILITY NUMBER:	097005555
ADMINISTRATOR:	DR. BENJAMIN FOULK		FACILITY TYPE:	740
ADDRESS:	2896 CENTERBURY CIRCLE		TELEPHONE:	(916) 933-0107
CITY:	EL DORADO HILLS	STATE: CA	ZIP CODE:	95762
CAPACITY:	6	CENSUS: 4	DATE:	07/17/2024
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	RCC Amanda Hinch		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff do not provide daily activities for residents in care
Staff are not meeting resident’s ALD needs
Facility is in disrepair, unsanitary and not odor free
Staff do not keep the facility free of mold

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024

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

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 59-AS-20240423110151

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: OAKRIDGE SENIOR CARE	FACILITY NUMBER: 097005555
	VISIT DATE: 07/17/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Staff do not provide daily activities for residents in care
Staff are not meeting resident’s ALD needs
Through the course of the investigation process, CCL conducted interviews, toured the facility, and reviewed records regarding the allegation above. During the investigation, resident and staff interviews indicated that residents are receiving all ADLs, including activities from care staff. Residents indicated that if they need anything staff are there and ready to assist. Residents indicated that all their needs are being met by facility staff. Staff indicated that they have never observed other care staff not providing ADLs, or activities to residents in care. Therefore, the above allegation is UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis.

Facility is in disrepair, unsanitary and not odor free
Staff do not keep the facility free of mold
Through the course of the investigation process, CCL conducted interviews, toured the facility, and reviewed records regarding the allegation above. During facility walk through on 4/30/24 and 7/17/24, it was observed that the facility is clean, sanitary, odor free and without mold. Therefore, the above allegation is UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis.

Exit interview conducted and copy of this report was left at the facility.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024

LIC9099 (FAS) - (06/04)

Page: 4 of 4