455001567-3-22-2022-25-AS-KHOS-CCYNQD-20220329103942

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 455001567
Report Date: 03/22/2022
Date Signed: 03/22/2022 01:19:34 PM

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
01/04/2022 and conducted by Evaluator Donna Gurriere

COMPLAINT CONTROL NUMBER: 25-AS-20220104091732

FACILITY NAME:	A BRAND NEW DAY		FACILITY NUMBER:	455001567
ADMINISTRATOR:	TAYLOR, VERNA		FACILITY TYPE:	740
ADDRESS:	779 KERRY-JEN COURT		TELEPHONE:	(530) 223-1538
CITY:	REDDING	STATE: CA	ZIP CODE:	96002
CAPACITY:	26	CENSUS: 22	DATE:	03/22/2022
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	SY MAJID		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Staff are smoking marijuana on the job.
A resident was being kicked out of the facility due to the resident's behaviors and dementia status.
A resident was refused re-admission upon discharge from the hospital.
The refrigerator is locked and food is unavailable to the residents.
Staff are refusing the home health aides to enter the facility.

INVESTIGATION FINDINGS:

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Donna Gurriere, Licensing Program Analyst was in contact and met with Sy Majid, Administrator. It was alleged that Staff are smoking marijuana on the job, A resident was being kicked out of the facility due to the resident’s behaviors and dementia status, A resident was refused readmission upon discharge from the hospital, The refrigerator is locked and food is unavailable to residents, and Staff are refusing the home health aides to enter the facility.

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.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rayna L Bryson	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Donna Gurriere	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022

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 5

Control Number 25-AS-20220104091732

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: A BRAND NEW DAY	FACILITY NUMBER: 455001567
	VISIT DATE: 03/22/2022

NARRATIVE

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During the investigation process, numerous documents were obtained and were reviewed depending on the allegation. Documents received and reviewed are as follows: Personnel Report, List of staff and resident names, correspondence to the Physician Assistant (PA), Medication Administrative Record (MARs), Medication Refill Request, Physician’s Report, Drug testing results, Staff corrective action report for incontinence, Relias Training Documents, Incident Reports, Training records and Contract Agreement for behavioral specialist facility.

Staff are smoking marijuana on the job.

During the investigation process, the licensee, the administrator, and six staff persons were interviewed. As mentioned above, documents were also reviewed.

It was reported by several staff persons that it may have been suspected that a staff person (S1) was smoking marijuana on the job because the staff person in question was seen “rolling” her cigarettes. The administrator sent the staff person in question to be drug tested and all drug tests came back negative. A report of the staff person’s negative results was provided to the licensing agency. Allegation is Unsubstantiated.

It could not be proven that Staff are smoking marijuana on the job. Although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred, and the findings are Unsubstantiated.

SUPERVISOR'S NAME: Rayna L Bryson	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Donna Gurriere	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 25-AS-20220104091732

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: A BRAND NEW DAY	FACILITY NUMBER: 455001567
	VISIT DATE: 03/22/2022

NARRATIVE

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A resident was being kicked out of the facility due to the resident’s behaviors and dementia status.

During the investigation process, the licensee, the administrator, six staff persons and a resident were interviewed. As mentioned above, documents were also obtained and reviewed.

It was reported by numerous staff persons that the resident (R1) was not kicked out of the facility due to the resident’s dementia status. It was stated that the resident was having behavioral problems to include aggression towards staff and residents and included urinating in various places in the facility. The licensee and administrator worked with the resident’s spouse and Physician’s Assistant (PA) to send the resident to a behavioral specialist facility in Reno, Nevada. An agreement was signed by the administrator stating that the resident’s current bed would be kept open and unoccupied until the resident returned. The resident was gone from the facility for approximately four weeks and has since returned. Allegation is Unsubstantiated.

It could not be proven that A resident was being kicked out of the facility due to the resident’s behaviors and dementia status. Although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred, and the findings are Unsubstantiated.

SUPERVISOR'S NAME: Rayna L Bryson	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Donna Gurriere	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 25-AS-20220104091732

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: A BRAND NEW DAY	FACILITY NUMBER: 455001567
	VISIT DATE: 03/22/2022

NARRATIVE

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A resident was refused readmission upon discharge from the hospital.

During the investigation process, the licensee, the administrator, six staff persons and a resident were interviewed. As mentioned above, documents were also obtained and reviewed.

It was reported by several staff persons including the Wellness Director that R1 was returned from the hospital to the facility via ambulance. The Wellness Director stated that she arrived at the facility within 20 minutes of the ambulance and that there was confusion as to if the resident could come back into the facility. The confusion came from another agency telling the staff that they did not have to take the resident back. The Wellness Director quickly reassessed the situation and the resident was allowed to reenter the facility without any other incident. Allegation is Unsubstantiated.

It could not be proven that A resident was refused readmission upon discharge from the hospital. Although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred, and the findings are Unsubstantiated.

SUPERVISOR'S NAME: Rayna L Bryson	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Donna Gurriere	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 25-AS-20220104091732

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: A BRAND NEW DAY	FACILITY NUMBER: 455001567
	VISIT DATE: 03/22/2022

NARRATIVE

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The refrigerator is locked, and food is unavailable to residents.
During the investigation process, the licensee, the administrator and six staff persons were interviewed. As mentioned above, documents were also obtained and reviewed.

During the interview process, it was reported that the refrigerator was locked for a very short time; however, when the staff were advised that they could not lock the refrigerator, it was unlocked immediately. It was stated by several staff that the residents did not go without food or snacks. Staff did report that the residents are provided with meals and snacks throughout the day and that snacks that are available to the residents include a fruit basket, juices and granola bars when requested. Allegation is Unsubstantiated.

It could not be proven that The food was unavailable to residents. Although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred, and the findings are Unsubstantiated.

Staff are refusing the home health aides to enter the facility.
During the investigation process, the licensee, the administrator and six staff persons were interviewed. As mentioned above, documents were also obtained and reviewed.

During the interview process it was stated by all staff persons that the allegation was untrue. It was reported that staff did not refuse home health aides to enter the facility, nor did anyone witness an aide being refused entry. Allegation is Unsubstantiated.

It could not be proven that Staff are refusing the home health aides to enter the facility. Although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred, and the findings are Unsubstantiated.

SUPERVISOR'S NAME: Rayna L Bryson	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Donna Gurriere	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022

LIC9099 (FAS) - (06/04)

Page: 5 of 5