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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455002192
Report Date: 09/25/2020
Date Signed: 09/25/2020 08:28:27 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASETT RD., STE. 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/15/2020 and conducted by Evaluator Misty Valencia
PUBLIC
COMPLAINT CONTROL NUMBER: 25-AS-20200615110421
FACILITY NAME:OAKDALE HEIGHTS OF REDDINGFACILITY NUMBER:
455002192
ADMINISTRATOR:BOBAN, KRISTINEFACILITY TYPE:
740
ADDRESS:101 QUARTZ HILL RDTELEPHONE:
(530) 241-6047
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY:75CENSUS: 75DATE:
09/25/2020
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Kristine Boban, AdministratorTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Personal Rights-Neglect/ lack of Care and supervision.
INVESTIGATION FINDINGS:
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Misty Valencia, Licensing Program Analyst (LPA) conducted an unannounced complaint investigation to deliver findings. LPA discussed the complaint regarding the following allegation as described above and deliver the findings, with Kristine Boban, Administrator.

Continued on 9099-C
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Rayna L BrysonTELEPHONE: (530) 895-5991
LICENSING EVALUATOR NAME: Misty ValenciaTELEPHONE: (530) 895-5820
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2020
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 25-AS-20200615110421
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 COHASETT RD., STE. 170
CHICO, CA 95926
FACILITY NAME: OAKDALE HEIGHTS OF REDDING
FACILITY NUMBER: 455002192
VISIT DATE: 09/25/2020
NARRATIVE
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Neglect lack of supervision; Resident (R1) sustained and fall while in the facility, subsequently leading to death as a result of lack and supervision by facility staff-Unfounded.

On 06/05/2020 at approximately 1445hrs, R1 exited the facility via wheelchair. While R1 was on her daily “walk” around the facility, R1 sustained a fall off the facility sidewalk. (Unwitnessed) R1 fell down a small hill of grass landing on a metal sewer panel. A good Samaritan found R1 at unknown time and reported the fall to the front desk of the facility. R1 was transported to Mercy Medical Hospital. The facility is an assistant living facility. The facility cannot lock the community doors, locking the client’s inside. The facility cannot limit residents from coming or going from the facility. R1 had full control over her mental function and needed limited care. The facility conducted checks on all clients every 2 hours. R1 was checked per facility policy prior to her fall. R1 lived at the facility for approximately one yea, she never sustained a fall or had any unusual incidents. R1 was not considered a fall risk.

This agency has investigated the above listed complaint allegations. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without reasonable basis. We have therefore dismissed the complaint.



There were no citations issued during today's visit, copy of report was given. An exit interview was conducted with Administrator and copy of the report given. .
SUPERVISOR'S NAME: Rayna L BrysonTELEPHONE: (530) 895-5991
LICENSING EVALUATOR NAME: Misty ValenciaTELEPHONE: (530) 895-5820
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2