342701286-7-23-2024-27-AS-KHOS-D83NH7-20240812102817

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342701286
Report Date: 07/23/2024
Date Signed: 07/23/2024 04:01:04 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
05/28/2024 and conducted by Evaluator Christina Valerio

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20240528100935

FACILITY NAME:	BEATRICE HOME CARE		FACILITY NUMBER:	342701286
ADMINISTRATOR:	CLARK, BEATRICE		FACILITY TYPE:	740
ADDRESS:	1014 FERNANDO WY		TELEPHONE:	(916) 270-3961
CITY:	GALT	STATE: CA	ZIP CODE:	95632
CAPACITY:	6	CENSUS: 5	DATE:	07/23/2024
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Beatrice Clark		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Facility staff did not ensure resident was treated with dignity

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to deliver complaint investigation findings. LPA Valerio met with facility staff, and explained the purpose of the visit. Administrator Beatrice stated staff can sign on her behalf.

The investigation consisted of interviews with the Reporting Party (RP), interviews with residents, Resident 1 (R1) - Resident 4 (R4), interviews with staff, Staff 1 (S1) - Staff 2 (S2), and observations of staff to resident interactions.

According to an interview with the RP, the RP was visiting a resident. The RP observed two staff on shift. While the RP was talking to the resident, the RP heard a someone in the back room yell in a loud tone, "Go to your room!" RP said the staff that was in the kitchen did not react.

Continues on LIC 9099 - C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024

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 27-AS-20240528100935

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: BEATRICE HOME CARE	FACILITY NUMBER: 342701286
	VISIT DATE: 07/23/2024

NARRATIVE

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Continued from LIC 9099

A few minutes later, the same person yelled again. The RP did not see what happened and only heard it. RP stated if any of their team members reacted that way to a resident, that person would not have a job. It was very unprofessional. RP could only provide the ethnicity and gender of the person believed to yell at the resident.

LPA Valerio interviewed four (4) residents. Based on interviews with R1, R2, R3, and R4, there was no indication or proof that staff have yelled at the residents or raised their voice at the resident.

LPA Valerio interviewed two (2) staff. Per S1, S1 stated the allegation is not true. S1 knows that S2 talks loudly but because some residents cannot hear and need to hear the words. S1 stated R4 needs staff to speak slow and loud so R4 can read the lips. S1 stated there is not a staff member that matches the RP description. S2 stated S2 has never yelled at the resident when talking to them.

LPA Valerio observed the facility on 05/29/2024, 06/13/2024, and 07/02/2024. LPA observed staff interactions to be professional, attentive, and caring. It should be noted that LPA observed Staff 2 to be the only person on shift during the visits.

Due to the above noted information, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, and therefore the allegations are unsubstantiated. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies cited. An exit interview was held and a copy of report was left at the facility.

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024

LIC9099 (FAS) - (06/04)

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