347001498-8-22-2023-59-AS-MSEY-CUZL5N-20230824082723

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347001498
Report Date: 08/22/2023
Date Signed: 08/22/2023 01:48:55 PM

Unfounded

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
08/18/2023 and conducted by Evaluator Sabrina Calzada

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20230818104727

FACILITY NAME:	CITRUS HEIGHTS TERRACE		FACILITY NUMBER:	347001498
ADMINISTRATOR:	EDITHA MCCULLOUGH		FACILITY TYPE:	740
ADDRESS:	7952 OLD AUBURN ROAD		TELEPHONE:	(916) 727-4400
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY:	45	CENSUS: 44	DATE:	08/22/2023
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Toni Jones, Administrator		TIME COMPLETED:	01:50 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility is not taking necessary precautions to prevent the spread of scabies

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to open a complaint investigation received anonymously on 8/18/23. LPA met with Toni Jones, Administrator, and explained purpose of inspection. LPA also briefly met wiith Ashley Stahl, Resident Care Coordinator (RCC).

LPA discussed the allegation with the Administrator, RCC and (2) caregivers. LPA observed resident rooms of residents who had a diagnosis of scabies and reviewed documentation. The results of the investigation are as follows:

LPA was informed of a scabies outbreak with (2) residents on 8/9/23, when resident (R1) was sent to the ER due to showing signs of itching and having a rash on her body. R1 returned the same day but without a diagnosis of scabies. R2 was also sent to the ER on 8/9/23 due to itching and having a rash that covered her whole body. R2 returned the same day with a diagnosis of scabies and prescription creme for treatment. LPA received a completed incident report (LIC624) for R1 and R2 on 8/11/23. Also on 8/11/23, LPA received a completed LIC624 for resident (R3) who went to the ER on 8/10/23 for the same signs of itching and a rash. R3 returned the same day with a diagnosis of scabies and prescription creme.
cont on 9099C-1...

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina Calzada	TELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023

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-20230818104727

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: CITRUS HEIGHTS TERRACE	FACILITY NUMBER: 347001498
	VISIT DATE: 08/22/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

9099C-1... LPA received a completed LIC624 for resident (R4) on 8/15/23 noting resident was sent to the ER on 8/12/23 for signs of itching and a rash. R4 returned the same day with a prescription creme for scabies. R4's roommate was moved from the shared room upon R4 showing signs/symptoms of scabies.

LPA and Administrator observed R1 and R2's lower arms on 8/22/23. R1 stated she still has some itching and needs another treatment; however, a staff stated that a nurse saw R1 yesterday and the rash has cleared and R1's arms commonly appear dry and red. R2 was observed to have a slight rash on her lower arms and was not able to state if her arms are itchy when asked. LPA and Administrator observed R3's room and observed an upholstered chair in the room. Administrator agreed to have the chair cleaned following the scabies outbreak. LPA observed R4's room to be clean and not contain any upholstered furniture.

LPA asked (2) staff if they were aware of any staff contracting scabies recently, and both said they were not. One staff confirmed that all (4) residents received both doses of the prescription treatment creme, affected residents had their clothing washed immediately following the diagnosis, on the NOC shift, and carpets/flooring was cleaned also. The same staff stated that R1 and R2 were seen by a nurse yesterday and R2 will be receiving a third dose of medication, which is expected to arrive by tomorrow, since R2 still has some rash visible. Staff asserted that all staff have been careful, "very cautious" and wearing PPE as required.

RCC confirmed there were (4) residents who contracted scabies in August 2023 and there have been no staff with this diagnosis. RCC confirmed all residents received two treatments of the prescription creme for scabies, she contacted local public health following each case and followed the facility's Infection Control Plan immediately following the first cases. LPA observed a quarantine sign to still be posted outside residents, R1 and R2's room. RCC indicated that all infected residents were quarantined in their room for the designated period and if the residents went in the common areas they were redirected back to their rooms.

LPA reviewed the Medication Administration Record (MAR) where it's noted R1 and R2 were administered the initial dose of Permethrin creme on 8/11/23; R4 on 8/12/23 and R3 on 8/15/23. Administrator to remind staff to enter their initials every time a dosage is administered.

Based on information obtained during the investigation, LPA finds this allegation to be UNFOUNDED-meaning that the allegation was false, could not have happened and/or is without reasonable basis.

Exit interview. Copy of report provided to the Administrator.

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina Calzada	TELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2