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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455001567
Report Date: 12/28/2022
Date Signed: 12/28/2022 09:51:12 AM


Document Has Been Signed on 12/28/2022 09:51 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926



FACILITY NAME:A BRAND NEW DAYFACILITY NUMBER:
455001567
ADMINISTRATOR:TAORMINO, BRITTNIEFACILITY TYPE:
740
ADDRESS:779 KERRY-JEN COURTTELEPHONE:
(530) 223-1538
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY:26CENSUS: 12DATE:
12/28/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:STACEY MILLERTIME COMPLETED:
10:45 AM
NARRATIVE
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Donna Gurriere, Licensing Program Analyst was in contact and met with Stacey Miller Health Services Director.

LPA Gurriere 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. The administrator/staff person was contacted to complete a facility risk assessment. LPA Gurriere ensured that hand sanitizer was applied before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 mask. Additionally, LPA Gurriere was screened by a staff person upon entering the facility.

During the investigation of complaint #455001567, it was noted that Lack of Care and Supervision was not provided to Resident #2.

During the interview process, several staff persons were interviewed. An attempted interview was made with the resident (Resident 2); however, she did not engage in conversation. A walk-through of the facility was conducted whereas residents’ well-being was observed, and several records were reviewed. Various documents were obtained and reviewed to include Physicians Report, Admission Agreement, Appraisal and Needs, Medication Administration Records (MARs), Incident Reports, and a list of staff names.

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SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (916) 263-4700
LICENSING EVALUATOR NAME: Donna GurriereTELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 12/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/28/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: A BRAND NEW DAY
FACILITY NUMBER: 455001567
VISIT DATE: 12/28/2022
NARRATIVE
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During the investigation process, medical records were obtained and documented history of Resident 2 sustaining multiple falls at the facility. On 03/03/22 at about 1600 hours the resident was transported to the hospital due to sustaining a laceration to the back of her head after an unwitnessed fall “sometime during the afternoon.” Staff reported that the resident had been a fall risk since the beginning of 2022. Staff stated that the resident required a higher level of care and supervision due to her wandering behavior and instability. Multiple staff reported that the facility was severely understaffed with only 1-2 care staff on shift at the time. There is a preponderance of evidence that Resident 2 sustained an unwitnessed fall and subsequent injury due to a lack of care and supervision.

Based on investigation observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be Substantiated. California Code of Regulations, (Title 22), is being cited on the attached LIC 9099D.

Appeal Rights were explained and provided to the facility representative listed above and an exit interview was conducted. If any of the cited deficiencies are not corrected by the noted due date; civil penalties may be assessed.

SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (916) 263-4700
LICENSING EVALUATOR NAME: Donna GurriereTELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:

DATE: 12/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/28/2022 09:51 AM - 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
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926


FACILITY NAME: A BRAND NEW DAY
FACILITY NUMBER: 455001567

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/28/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/29/2022
Section Cited

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Personal Rights of Residents in all facilities – Residents in all residential care facilities for the elderly shall have all of the following comfortable accommodations…
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The licensee agrees to submit a plan of correction to the licensing agency to advise how this citation will be avoided in the future.
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This requirement is not met as evidenced by based upon interviews, the licensee failed to provide a resident with safe, healthful and comfortable accommodations. This poses an immediate Health, Safety and or Personal Rights risk to residents in care.
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This is the second violation within a one-year period. Licensee shall be given civil penalties. Last citation was on 04/28/22.

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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: Anthony PerezTELEPHONE: (916) 263-4700
LICENSING EVALUATOR NAME: Donna GurriereTELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 12/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/28/2022
LIC809 (FAS) - (06/04)
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