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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347001498
Report Date: 12/03/2021
Date Signed: 12/03/2021 09:43:11 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/20/2021 and conducted by Evaluator DeAnna Williams-Lyons
PUBLIC
COMPLAINT CONTROL NUMBER: 25-AS-20210720093422
FACILITY NAME:CITRUS HEIGHTS TERRACEFACILITY NUMBER:
347001498
ADMINISTRATOR:TINA PREWITTFACILITY TYPE:
740
ADDRESS:7952 OLD AUBURN ROADTELEPHONE:
(916) 727-4400
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:45CENSUS: 44DATE:
12/03/2021
UNANNOUNCEDTIME BEGAN:
09:14 AM
MET WITH:Tina Prewitt, Executive DirectorTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Staff did not provide adequate care and supervision to residents.

Staff did not treat resident with dignity and respect.
INVESTIGATION FINDINGS:
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On 12/3/2021, Licensing Program Analyst (LPA) DeAnna Williams-Lyons arrived unannounced to deliver findings for complaint # 25-AS-20210720093422. LPA met with Tina Newton, Executive Director, and explained the reason for the visit. Prior to initiating the visit, LPA completed the required COVID-19
Testing Protocols, and a daily self- screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms, and completed a facility risk assessment. LPA ensured she applied hand sanitizer before entering the facility and a mask was worn for Personal Protective Equipment (PPE).
Additionally, LPA was screened by front desk personnel.
Throughout the course of the investigation, the Department reviewed facility notes, conducted interviews with residents and staff, reviewed resident file, and obtained relevant documentation and evidence.

LPA interviewed 5 staff and 5 residents who all report that they have never witnessed any residents to not have their needs met. All 5 residents report they have all their needs met and have never had any issues getting them met. In addition, no staff or resident has ever heard staff treating residents without dignity and respect.
To continue see 9099 C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: DeAnna Williams-LyonsTELEPHONE: (916) 212-3983
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2021
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 25-AS-20210720093422
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: CITRUS HEIGHTS TERRACE
FACILITY NUMBER: 347001498
VISIT DATE: 12/03/2021
NARRATIVE
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Based on interviews and observation and records reviewed, LPA has determined the allegation to be UNSUBSTANTIATED, which means, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, and the findings are UNSUBSTANTIATED

Per California Code of Regulations, no citations were issued.

An exit interview was conducted and a copy of this report was given to Tina Newton.
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: DeAnna Williams-LyonsTELEPHONE: (916) 212-3983
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2021
LIC9099 (FAS) - (06/04)
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