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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347003884
Report Date: 05/15/2024
Date Signed: 05/21/2024 03:29:04 PM

Unfounded


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
04/29/2024 and conducted by Evaluator Arvin Villanueva
COMPLAINT CONTROL NUMBER: 27-AS-20240429152716
FACILITY NAME:TAHOE, THEFACILITY NUMBER:
347003884
ADMINISTRATOR:DESCARGAR, BERNADETTEFACILITY TYPE:
740
ADDRESS:8708 SECKEL COURTTELEPHONE:
(916) 686-5715
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY:6CENSUS: 5DATE:
05/15/2024
UNANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:Bernadette DescargarTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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9
Staff does not ensure water temperature is within regulation standards.
INVESTIGATION FINDINGS:
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{This is an amended version of the report originally created on 5/15/24}
On 5/15/24, at 10:04am, Licensing Program Analyst (LPA) Arvin Villanueva arrived at this facility unannounced to conduct a follow up complaint investigation regarding the allegation noted above and deliver the findings. LPA met with the facility administrator, Bernadette Descargar, and explained the purpose of the visit. Present during this visit, were 5 residents in care with 3 staff on duty. Additionally, an outside agency was also present assisting some residents in care.

During this visit, LPA and facility manager (S1) conducted hot water temperature check in all 3 resident bathrooms and the kitchen sink. LPA and S1 each have their own thermometer to use. Additionally, LPA utilized a digital stopwatch to time how long each faucet reaches 105 degrees F. Per observation, hot water temperature in all 3 bathrooms and kitchen faucet were within regulatory standard, between 105 degrees F and 120 degrees F.

{Con't to LIC9099-C...}
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
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 2
Control Number 27-AS-20240429152716
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: TAHOE, THE
FACILITY NUMBER: 347003884
VISIT DATE: 05/15/2024
NARRATIVE
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{...Con't from LIC9099}

During an unannounced visit on 5/6/24, LPA and S1 also conducted hot water temperature check on all 3 resident bathrooms and the kitchen sink. Per observation, hot water temperature in all 3 bathrooms and kitchen faucet were within regulatory standard between, 105 degrees F and 120 degrees F. Additionally, required unannounced annual visits were conducted on 12/06/23, 11/18/22, and 11/03/21. LPAs conducted these visits observed the measurement of the facility’s hot water temperature were within regulatory standard, between 105 degrees F and 120 degrees F.

Based on observation and interviews, the allegation that staff does not ensure water temperature is within regulation standards has been determined to be UNFOUNDED. A finding of unfounded means that the allegations are false, could not have happened, or is without a reasonable basis.

An exit interview was conducted with Bernadette Descargar, administrator, and a copy of this report and appeal rights were provided.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2