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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700721
Report Date: 03/27/2023
Date Signed: 03/27/2023 03:16:31 PM


Document Has Been Signed on 03/27/2023 03:16 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833



FACILITY NAME:DIAMOND CARE INC.FACILITY NUMBER:
392700721
ADMINISTRATOR:CARIE SONODGRASSFACILITY TYPE:
740
ADDRESS:7910 BRIGHT RDTELEPHONE:
(209) 914-2859
CITY:FRENCH CAMPSTATE: CAZIP CODE:
95231
CAPACITY:16CENSUS: 14DATE:
03/27/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Zachary Murphy-DuncanTIME COMPLETED:
03:30 PM
NARRATIVE
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On 3/27/23 Licensing Program Analysts (LPAs) Maja Jensen and Jennifer Fain arrived at facility unannounced to conduct a case management related to an LIC 624A. LPAs Jensen and Fain met with Administrator Zachary Murphy-Duncan and explained the purpose of today's visit.

On January 3, 2023, the Department received an LIC 624A reporting a death that occurred on 12/22/22 which is after the 7 day regulatory requirement.

A deficiency is being cited from the California Code of Regulations (CCR) Title, 22, Division 6. Failure to correct deficiencies may result in an assessment of civil penalties.

An exit interview was conducted and a copy of this report and appeal rights were provided.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Maja JensenTELEPHONE: 916-639-5584
LICENSING EVALUATOR SIGNATURE:
DATE: 03/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/27/2023 03:16 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833


FACILITY NAME: DIAMOND CARE INC.
FACILITY NUMBER: 392700721

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/31/2023
Section Cited

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Reporting Requirements
A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. ...
Death of any resident from any cause regardless of where the death occurred, including but not limited to a day program, a hospital, en route to or from a hospital, or visiting away from the facility. This requirement was not met as evidenced by:
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The licensee agrees to implement a system where unusual incents are placed on calendar on the date of occurence and if no report has been sent within 2 days the Administrator will receive a calendar notification alert. Licensee will email maja.jensen@dss.ca.gov confirmation that this system of checks and balances has been implemented.
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Based on LPA Jensen's review of an LIC 624A that was faxed on 1/3/23 for a death that occured 12/22/23 which falls outside of teh reporting requirement timeframe. This poses a potential health, safety and personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Maja JensenTELEPHONE: 916-639-5584
LICENSING EVALUATOR SIGNATURE:
DATE: 03/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/27/2023
LIC809 (FAS) - (06/04)
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