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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347001696
Report Date: 05/05/2021
Date Signed: 05/05/2021 01:45:54 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/25/2021 and conducted by Evaluator Melana Llopis
COMPLAINT CONTROL NUMBER: 27-AS-20210125112352
FACILITY NAME:LA HONDA GUEST HOMEFACILITY NUMBER:
347001696
ADMINISTRATOR:TORRES, MARGARITAFACILITY TYPE:
740
ADDRESS:3940 LA HONDA WAYTELEPHONE:
(916) 944-8909
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:6CENSUS: 5DATE:
05/05/2021
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Administrator, Neal TorresTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff mismanaged resident's medication.
Resident was not provided nutritious meals.
Resident's bathing needs were not being met.
Resident was not provided clean linen.
Staff handled resident in a rough manner.
Staff did not treat resident with dignity and respect
Staff did not ensure water temperature was appropriate for resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Llopis contacted the facility unannounced on 05/05/2021 via telephone due to Covid-19 and precautionary measures to deliver complaint findings for a complaint the Department received on 01/25/2021. LPA spoke with the Administrator, Neal Torres and explained the purpose of the call.

Throughout the course of the investigation, LPA conducted multiple interviews, toured the facility, and reviewed documentation pertinent to the allegations listed above.

Results are as follows:

***Continuation on LIC9099-C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kevin Mknelly
LICENSING EVALUATOR NAME: Melana Llopis
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2021
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 27-AS-20210125112352
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: LA HONDA GUEST HOME
FACILITY NUMBER: 347001696
VISIT DATE: 05/05/2021
NARRATIVE
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Allegation: Staff mismanaged resident's medication.
Complaint alleged the facility was not ensuring resident's medications were being refilled timely. On 04/21/2021 LPA conducted a medication audit for three (3) residents in care. LPA compared the resident's medication list to their MARS sheet for the months of January 2021, February 2021 and March 2021. LPA observed no errors. LPA spoke to three (3) of five (5) residents in care who stated "as far as they knew, they were receiving their medications." Facility staff stated the Administrator handles medication orders. The Administrator stated they check medication supply at least once a day. When there is only a 7 day supply left of medications the Administrator will call into the pharmacy to refill the prescription. No further evidence could be provided.

Allegation: Resident was not provided nutritious meals.
Complaint alleged resident was not provided a nutritious meal by the facility staff during their residence. On 04/21/2021, 04/23/2021 and 04/30/2021 LPA interviewed three of three (3) staff who stated the facility provides three (3) meals a day with two (2) snacks in between. On 04/30/2021 in the afternoon, S2 stated the residents had the following for lunch: cooked chicken, fruit, macaroni salad, 3 bean salad, cranberry juice and water. On 05/03/2021 LPA reviewed facility menu provided which indicated the residents are being provided three (3) balanced meals a day. No further evidence was available for review.

Allegation: Resident's bathing needs were not being met.
Complaint alleged resident was only receiving a bath every four (4) days. On 04/21/2021 and 04/23/2021 LPA interviewed three (3) of three (3) staff who stated residents receive baths/showers every Sunday, when requested, and as needed. Staff also stated that between baths, staff will clean and wipe residents down to ensure they are odorless and dry. On 04/21/2021 and 04/23/2021 LPA interviewed three (3) of five (5) residents in care who stated they receive showers once a week, upon request and as needed. R5 stated they are independent and are able to shower themself. R2 stated they are cleaned in between their showers by S3. No shower records were able to be provided for review. LPA spoke with key witness on 04/29/2021 who stated during their visits R1 appeared to be well-groomed, showered, and odorless.

***Continuation on LIC9099-C***
SUPERVISORS NAME: Kevin Mknelly
LICENSING EVALUATOR NAME: Melana Llopis
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20210125112352
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: LA HONDA GUEST HOME
FACILITY NUMBER: 347001696
VISIT DATE: 05/05/2021
NARRATIVE
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Allegation: Resident was not provided clean linen.
Complaint alleged resident did not receive clean linen for the time of their residence. LPA toured the facility on 04/23/2021 and observed resident's rooms and bedsheets. LPA observed rooms to be clean and in good repair. LPA found sheets to appear clean, dry and odorless. LPA observed the linen closet to be stocked with a sufficient amount of clean linens. During LPA's visit on 04/23/2021 LPA interviewed three (3) residents in care who stated the facility changes their sheets weekly and sometimes daily as need. On 04/29/2021 LPA interviewed a key witness who stated during their visits, R1's bedsheets appeared clean and dry.

Allegation: Staff handled resident in a rough manner.
Complaint alleged S1 handled resident in a rough manner when providing bathing. On 04/21/2021 and 04/23/2021 LPA interviewed three (3) of five (5) residents in care. Residents stated the staff treat them well and take good care of them. On 04/21/2021 and 04/23/2021 LPA interviewed three (3) of three (3) staff who stated they have not witnessed residents treated in a rough manner by other staff. No further evidence could be provided.

Allegation: Staff did not treat resident with dignity and respect.
Complaint alleged S1 did not treat resident with dignity and respect when providing resident with a shower. On 04/21/2021 and 04/23/2021 LPA interviewed three (3) of five (5) residents in care. Residents stated the staff are "very good and very nice." On 04/23/2021 interview with S2 stated S1 would bathe R1. S2 stated they would assist S1 when bathing R1. S2 stated S1 would sit R1 in a chair in the shower and wash R1 with soap and shampoo and rinse R1 with warm water. S2 stated R1 did not state the water was too hot. S2 stated they did not witness S1 treat R1 with disrespect.

Allegation: Staff did not ensure water temperature was appropriate for resident.
Complaint alleged S1 did not ensure the water temperature was appropriate for resident when providing resident with a shower. On 04/23/2021 LPA interviewed two (2) residents in care who stated the shower water is warm and not too hot. Residents interviewed stated the water felt like the appropriate temperature. Interviews with two (2) of three (3) staff interviewed on 04/23/2021 stated they test the temperature of the water before washing the residents. Key witness stated on 04/30/2021 when they visited the facility they washed their hands in the bathroom sink and the water was warm and not too hot. On 05/03/2021 LPA reviewed facility's last annual inspection which shows the water temperature was last measured within the required range.

Due to the above information, LPA finds the allegations listed above to be UNSUBSTANTIATED, meaning
that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, and the findings are unsubstantiated.

Exit interview conducted with Administrator, copy of report and appeal rights provided. Administrator to send a signed copy to LPA by 05/06/2021.

SUPERVISORS NAME: Kevin Mknelly
LICENSING EVALUATOR NAME: Melana Llopis
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3