complaint·May 4, 2021

Admin found the above fax number on the CDSS.ca.gov home page, which is for CCLD’s main regional office, and not the Sacramento North Regional Office Fax number (916) 263-4744. Admin attempted to submit the LIC624’s to LPA, but did not ensure the correct fax number was being used. LPA did not receive the LIC624’s via fax, and did not follow up with facility regarding COVID-19 Positives until notified 12/23/2020 by RP. LPA received date stamped documentation of faxes sent. Through documents reviewed and interviews conducted, it is determined the allegation of “Reporting Requirements” to be UNSUBSTANTIATED. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted. LPA reviewed complaint with licensee, and will send a copy of report by email along with a read receipt. LPA informed admin to sign and return one copy by COB 5/5/2021. LPA Leitzell did not receive LIC624’s due to the Fax number being for CCLD’s main regional office, and not the Sacramento North Regional Office Fax number (916) 263-4744. LPA did not follow up with facility until RP notified LPA of positives on 12/23/2020. Per the Provider Information Notice 20-23-Adult and Senior Care (PIN 20-23-ASC), facilities are to conduct mass testing as soon as possible after one (or more) COVID-19 positive individual is identified in a facility, every 14 days until no new cases are identified in two sequential rounds of testing. Facility is also to isolate positive individuals away from negative, wear PPE while at the facility, and ensure positive staff are not working with negative residents per PIN 20-23-ASC. Through interviews conducted and documentation reviewed, LPA was able to prove facility ensured the requirements set forth were met with guidance and continuous communication with Sacramento CDPH RN. Based on the information gathered, the above allegations are found to be UNFOUNDED. A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. Exit interview conducted. LPA reviewed complaint with licensee, and will send a copy of report by email along with a read receipt. LPA informed admin to sign and return one copy by COB 5/5/2021.