455002481-11-1-2022-25-AS-TORZ-CLA385-20221117170055

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 455002481
Report Date: 11/01/2022
Date Signed: 11/01/2022 01:07:03 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 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
09/14/2022 and conducted by Evaluator Rebecca Knight

COMPLAINT CONTROL NUMBER: 25-AS-20220914145433

FACILITY NAME:	NEW VISION SERVICES, INC. 2		FACILITY NUMBER:	455002481
ADMINISTRATOR:	LANDER-WILLIAMS, EVELYN		FACILITY TYPE:	735
ADDRESS:	2897 BALATON AVENUE		TELEPHONE:	(530) 229-9195
CITY:	REDDING	STATE: CA	ZIP CODE:	96001
CAPACITY:	4	CENSUS: 4	DATE:	11/01/2022
		UNANNOUNCED	TIME BEGAN:	12:01 PM
MET WITH:	Evelyn Williams - Licensee		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff is retaliating against resident for a complaint - UNSUBSTANTIATED
Staff not following physician's orders - UNSUBSTANTIATED

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

11/01/2022 10:00 AM Licensing Program Analyst (LPA) Rebecca Knight, made an unannounced visit to the facility and met with licensee Evelyn Williams and administrator Melissa Johnson. The purpose of this visit was to deliver the results of the complaint investigation of the above allegations. Prior to initiating the visit, LPA completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N95 Mask, gloves. In addition, LPA was screened by facility staff.
During the course of the investigation 2 administrators and 5 staff were interviewed. LPA obtained the following documents to investigate the above allegations: Physician’s Report, IPP, Admission Agreement, prescription, staff list with phone numbers, client list, fax log, prescription for glucose monitoring.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022

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 3

Control Number 25-AS-20220914145433

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: NEW VISION SERVICES, INC. 2	FACILITY NUMBER: 455002481
	VISIT DATE: 11/01/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Administrator stated the health clinic sent the prescription to the pharmacy but not to the facility, the facility didn’t know there was an order. The prescription was denied twice by the insurance company because C1 isn't diabetic. The prescription was written on 5/25/2022 according to Shasta Community Health Center. The facility received it on 9/14/2022. The pharmacy said they received the prescription sometime in June 2022. On 6/08/2022 the clinic called the facility and asked if they were testing C1’s blood sugar. Staff told the Shasta Community Health nurse that the facility was unaware that they were supposed to be testing C1’s blood sugar. Staff told them they need an order and they said they would call the facility back. The health clinic never called the facility back. The health clinic sent the prescription to the pharmacy but the facility was not aware. The pharmacy tried to run the prescription through both insurances, and it was denied due to lack of diagnosis. Even though the insurance denied coverage of the prescription, the licensee bought testing supplies with their own money once the order was received from the pharmacy on 9/14/2022, and staff started testing C1’s blood sugar daily thereafter.

It was determined that C1’s physician did prescribe daily blood sugar testing on May 25, 2022 but the facility was not notified of this by the health clinic. The facility received the prescription from the health clinic in September 2022, the prescription was denied twice by C1’s insurance company. As a result, the licensee used their own money to purchase the blood sugar test kit and immediately started testing C1’s blood sugar each day. This allegation is unsubstantiated.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are UNSUBSTANTIATED.

An exit interview was conducted. A copy of the report was emailed to facility license Evelyn Williams. No deficiency cited.

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 25-AS-20220914145433

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: NEW VISION SERVICES, INC. 2	FACILITY NUMBER: 455002481
	VISIT DATE: 11/01/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Staff is retaliating against resident for a complaint – UNSUBSTANTIATED

It was alleged that staff retaliated against a resident as a result of a prior complaint being filed. The form of the retaliation was the facility took the male residents on a camping trip but did not take the female residents.

During staff interviews it was learned that the facility took the male clients on a camping trip but did not take Client 1 (C1). The reason the female clients did not go on the trip was to keep C1 safe.

Administrator stated We didn’t feel that we could have provided enough supervision to keep C1 safe on the trip. Instead of the women going on the camping trip we rented an Air BNB, they went to the Oasis fun center, an alpaca farm, out to lunch and breakfast. The girls were fine with that.

It was determined that there if no evidence that staff retaliated against C1 as a result of a prior complaint, therefore this allegation is unsubstantiated.

Staff not following physician's orders - UNSUBSTANTIATED

LPA review of documents revealed that C1’s physician issued a “Generic prescription for check blood sugar once daily” dated May 25, 2022. LPA reviewed a fax from the pharmacy dated September 27, 2022 for a prescription that was written on 06/09/2022 for an Accu-Check Aviva Plus Meter. This same fax included a denial from C1’s insurance company due to patient not fitting eligibility. LPA review of C1’s physician report dated 6/15/2021 does not include a diabetes diagnosis.

LPA interview with Far Northern Regional Center Service Coordinator revealed that C1 has recently been taken off the drug Metformin.

During staff interviews it was learned that staff have been testing C1’s blood sugar daily since September 2022.

Continued on LIC9099-C

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3