570316115-7-20-2021-21-AS-KMOA-C5CM2K-20210728091340

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 570316115
Report Date: 07/20/2021
Date Signed: 07/20/2021 03:29:58 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/01/2021 and conducted by Evaluator Christopher Arnhold

PUBLIC

COMPLAINT CONTROL NUMBER: 21-AS-20210401162913

FACILITY NAME:	CALIFORNIAN, THE		FACILITY NUMBER:	570316115
ADMINISTRATOR:	KATHY B. NEESER		FACILITY TYPE:	740
ADDRESS:	1224 COTTONWOOD STREET		TELEPHONE:	(530) 666-2433
CITY:	WOODLAND	STATE: CA	ZIP CODE:	95695
CAPACITY:	130	CENSUS: 83	DATE:	07/20/2021
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Kathy Neeser		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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Staff failed to meet the residents' needs due to insufficient staffing

Staff failed to respond to resident's call button in a timely manner

INVESTIGATION FINDINGS:

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At approximately 9:30AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility to complete an investigation into the above allegations. LPA met with Administrator Kathy Neeser, interviewed staff and reviewed records. LPA reviewed staffing schedules and resident call for service logs for the month of February 2021. On the day this incident was alleged to have occurred, the facility had staff on each shift to met the residents needs. LPA reviewed call logs for several days prior to and after the date the incident was alleged to have occurred. The average time for a staff to respond to a resident was 4 minutes. LPA did not find an occurrence in this time range when a staff failed to responds to a residents call for assistance. This agency has investigated the above allegations. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.
This report was reviewed with Administrator. No citations issued.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021

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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