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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700012
Report Date: 01/31/2025
Date Signed: 01/31/2025 02:43:41 PM

Document Has Been Signed on 01/31/2025 02:43 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:TWIN RIVERS AT NATOMASFACILITY NUMBER:
342700012
ADMINISTRATOR/
DIRECTOR:		GENAYA REESEFACILITY TYPE:
740
ADDRESS:421 SAN JUAN ROADTELEPHONE:
(916) 216-3058
CITY:SACRAMENTOSTATE: CAZIP CODE:
95834
CAPACITY: 48CENSUS: 37DATE:
01/31/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Rosa LesuiTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
NARRATIVE
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On January 31, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a case management visit regarding an incident report the Department received. LPA met with med-tech and explained the purpose of the visit.

Additionally, LPA spoke with Administrator on the phone to inform Administrator of LPA's purpose.

Incident report revealed that on January 28, 2025, it was reported to the Administrative Office by S1 that S2 had obtained a photo of R1's credit card and purchased shoes online with R1's credit card information. S1 had returned the shoes and provided Administrator the refund to return to R1.

LPA and Administrator discussed the following incident. Administrator stated S1 noticed that S2 had new shoes and when asked how did S2 afford them. S2 stated S2 took a photo of R1's credit card information and made purchases. Administrator informed LPA that S2 was terminated from the facility due to performance issues, prior to the awareness the financial abuse.

Administrator stated she took immediate actions and made a police report and additionally, worked with R1's payee services to get the credit card successfully canceled. Administrator stated the shoe refund has not been given to R1 yet as R1 is currently out of the facility.

As a result of the reported behavior of S2, deficiencies was cited. LPA explained that although facility took appropriate actions, since the incident did occurred at the facility, it was a violation against personal rights.

Exit interview and a copy of report and appeal rights provided.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Cassie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/31/2025 02:43 PM - It Cannot Be Edited


Created By: Cassie Yang On 01/31/2025 at 01:17 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: TWIN RIVERS AT NATOMAS
FACILITY NUMBER: 342700012

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2025
Section Cited
CCR
87468.2(a)(8)

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87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities... (8) To be free from neglect, financial exploitation... This requirement is not met as evidenced by:
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S2 is no longer working at the facility.

Licensee is to conduct an Elder Abuse training for all staff. Proof of training along with name of attendees are due to LPA Yang via fax or email by February 28, 2025.
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Based on file review, Licensee did not comply as incident report revealed S2 obatined R1's credit card information and purchased shoes, which poses a potential risk for 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:Anthony Perez
LICENSING EVALUATOR NAME:Cassie Yang
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2025


LIC809 (FAS) - (06/04)
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