502701207-9-4-2025-27-AS-LRIS-DLBNCR-20250908102111

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 502701207
Report Date: 09/03/2025
Date Signed: 09/04/2025 03:50:46 PM

Substantiated

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
05/21/2025 and conducted by Evaluator Ellen Lindstrom

COMPLAINT CONTROL NUMBER: 27-AS-20250521081550

FACILITY NAME:	BELMARE SENIOR LIVING		FACILITY NUMBER:	502701207
ADMINISTRATOR:	CINDY LICHTENHAN		FACILITY TYPE:	740
ADDRESS:	1450 WEST F STREET		TELEPHONE:	(209) 764-3164
CITY:	OAKDALE	STATE: CA	ZIP CODE:	95361
CAPACITY:	114	CENSUS:	DATE:	09/03/2025
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Lacy Vincent, Administrator		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Facility staff does not answer pendant calls in a timely manner.

INVESTIGATION FINDINGS:

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On 9/03/2025, Licensing Program Analysts (LPA) Triel Ellen Lindstrom and Arielle Pascua arrived unannounced at the facility to deliver the findings on a complaint received on 5/1/2025. The LPA met with Administrator Lacy Vincent and explained the purpose of the visit. LPA Lindstrom had toured and made observations at the facility, reviewed records and work schedules, and interviewed residents, staff, and family members. This investigation was conducted during site visits on 5/5/25, 5/28/25, 6/9/2025 and 8/4/2025.

Allegation: Facility staff does not answer pendant calls in a timely manner
On 5/5/25, LPA Pascua interviewed S7, who stated that the expectation regarding response time to pendant calls was 10 minutes. An analysis of the pendant log for April 2025 showed that the wait 11-20 minutes 21% of the time, 21 to 30 minutes 5% of the time, and over 30 minutes 3% of the time. LPA Lindstrom interviewed a resident R6, who stated that when the facility is not sufficiently staffed, it can take
(Continued on 9099-D)

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Ellen Lindstrom
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025

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-20250521081550

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: BELMARE SENIOR LIVING	FACILITY NUMBER: 502701207
	VISIT DATE: 09/03/2025

NARRATIVE

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staff up to an hour to respond to calls for help, often times leaving R6 screaming as they cannot reach the call button. R7 stated that staff response time to her call button is usually around 15-20 minutes, although has taken up to 30 to 45 minutes.

The Department has concluded, based on the preponderance of the evidence obtained during this investigation, that staff did not answer resident's call button in a timely manner, therefore the allegation of is SUBSTANTIATED. No deficiencies are being cited as this regulation is being cited today under complaint control # 27-AS-20250501155055.

An exit interview was conducted with the facility administrator. Appeal Rights were issued, and a copy of this report was left at the facility.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Ellen Lindstrom
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025

LIC9099 (FAS) - (06/04)

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