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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347005010
Report Date: 10/16/2024
Date Signed: 10/16/2024 10:58:27 AM

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
09/24/2024 and conducted by Evaluator Talwinder Bains
COMPLAINT CONTROL NUMBER: 59-AS-20240924122440
FACILITY NAME:ALL SEASONS, LLCFACILITY NUMBER:
347005010
ADMINISTRATOR:ANATOLIY MOLITVENIKFACILITY TYPE:
740
ADDRESS:8731 CENTRAL AVENUETELEPHONE:
(916) 776-6665
CITY:ORANGEVALESTATE: CAZIP CODE:
95662
CAPACITY:6CENSUS: 5DATE:
10/16/2024
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Resident Care Manager , Alma CaniedoTIME COMPLETED:
09:30 AM
ALLEGATION(S):
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Staff did not provide a safe environment for residents in care.
Staff did not prevent a resident from exposing himself to other residents in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced on 10/16/24 to deliver complaint findings for above allegations. LPA met with Resident Care Manager , Alma Caniedo and explained the purpose of the visit.

The department conducted records review ,facility observations and interviews to investigate the complaint.



**Report continued on LIC9099-C**
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024
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 59-AS-20240924122440
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: ALL SEASONS, LLC
FACILITY NUMBER: 347005010
VISIT DATE: 10/16/2024
NARRATIVE
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***Report continued from 9099........

Allegation- Staff did not provide a safe environment for residents in care. Staff did not prevent a resident from exposing himself to other residents in care. Unsubstantiated.

The Department conducted records review, interviews with staff and residents to investigate these allegations. Six (6) residents interviews conducted on 09/25/24 indicated that residents care needs were met per their needs and service plans and there were no concerns. Residents interviews reflected that resident, R1 has dementia with behaviors and R1 can be challenging sometimes with other individuals but staff able to redirect them in safe and professional manner. Residents interviews indicated that residents felt safe at facility and were receiving good care from staff. Four (4) staff interviews conducted on 09/25/24, reflected that there were no concerns from any resident or family with residents care. Staff were well aware about resident, R1 who got admitted to facility on 08/12/24 from other facility where they were residing at memory care unit. Staff verbalized that R1 has diagnosis of dementia and R1 can be challenging sometimes with staff. There were few incidents where R1 was non-co-operative with staff and resistive to their care due to their medical issues. Staff and residents indicated that R1 has been seen not properly dressed in common areas as R1 has poor awareness of their surroundings due to their dementia diagnosis. Per record review , there were no indication of R1 having any behaviors related to their dementia as noted in R1s pre-appraisal done by facility prior to R1s admission, however R1 started exhibiting challenging behaviors within few days when they got admitted to facility. Record review reflected that facility was continually working with R1s physicians and family to manage R1s behaviors with adjustments in their medications and other possible ways. Additionally, facility was providing required training's to staff regarding working with dementia residents on on-going basis and providing the adequate staffing to take care of R1 and other residents. Based on this information, these allegations were found to be Unsubstantiated means Although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove that the alleged violation(s) occurred.

Exit interview conducted. Copy of the report was provided.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2