455002049-11-30-2023-59-AS-KHOS-CYAR9Y-20231207115020

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 455002049
Report Date: 11/30/2023
Date Signed: 11/30/2023 01:35:12 PM

Unsubstantiated

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
09/14/2023 and conducted by Evaluator Ivan Avila

COMPLAINT CONTROL NUMBER: 59-AS-20230914092705

FACILITY NAME:	VISTAS ASSISTED LIVING & MEMORY CARE, THE		FACILITY NUMBER:	455002049
ADMINISTRATOR:	NATE ECHOLS		FACILITY TYPE:	740
ADDRESS:	3030 HERITAGETOWN DRIVE		TELEPHONE:	(530) 222-8969
CITY:	REDDING	STATE: CA	ZIP CODE:	96002
CAPACITY:	100	CENSUS: 73	DATE:	11/30/2023
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Nate Echols		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff are not addressing residents who are exhibiting fall risk behaviors

INVESTIGATION FINDINGS:

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On November 30, 2023 Licensing Program Analyst (LPA) Ivan Avila conducted an announced complaint investigation visit regarding the above allegation directed by the Department. LPA Avila met with Nate Echols and explained the reason for the visit.

On 08/31/2023 R1 had a fall and sustained a skin tear on right hand and nosebleed. NOC shift notes stated that R1 was running down the halls and two falls were witnessed by staff. The first was caused by R1 running by double doors in the common area and ran into the wall. The second fall was due to R1 tripping over a recliner and hit their shoulder. Staff could not prevent R1 from falling but continued to monitor R1s activities.

Continued on LIC9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Ivan Avila	TELEPHONE: (559) 974-4915
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 59-AS-20230914092705

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: VISTAS ASSISTED LIVING & MEMORY CARE, THE	FACILITY NUMBER: 455002049
	VISIT DATE: 11/30/2023

NARRATIVE

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During the investigation process interviews and a records review was initiated. LPA Avila reviewed incident reports and physician report. Records reviewed indicated that resident falls are in large part due to physical and medical implications. LPA Avila reviewed facility records and each fall was documented and sent to the Department and Hospice Services. The facility has updated care plans for residents addressing fall behaviors.

According to R1s physician’s report that was completed on 09/05/2023, R1 is ambulatory. R1 is not a fall risk. The physician report stated facility is to provide physical assistance to and from the dining room and or community activities as needed. Interviews that were conducted stated when residents would fall, staff immediately would assist residents. A minimum of two staff members would assist the resident who had fallen.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Exit interview was conducted and a copy of the report was provided to Nate Echols.

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Ivan Avila	TELEPHONE: (559) 974-4915
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2023

LIC9099 (FAS) - (06/04)

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