455002481-8-16-2024-59-AS-KHOS-D92H7Q-20240912055703

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 455002481
Report Date: 08/16/2024
Date Signed: 08/16/2024 01:45:59 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
04/04/2024 and conducted by Evaluator Sarah Benson

COMPLAINT CONTROL NUMBER: 59-AS-20240404101858

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:	08/16/2024
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Evelyn Lander-Williams Administrator		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Care and supervision: staff did not seek medical attention for the resident in a timely manner.
Illegal eviction.
Care and supervision: residents care needs were not met..

INVESTIGATION FINDINGS:

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

On 08-16-24 at 1:15 PM Licensing Program Analyst (LPA) Sarah Benson made an unannounced visit to the facility and met with Evelyn Lander-Williams, Melissa Johnson Administrator. The purpose of this visit was to deliver the results of a complaint investigation.

During the course of the investigation the administrator and staff were interviewed. Relevant documents were requested and reviewed.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sarah Benson
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2024

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 59-AS-20240404101858

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: NEW VISION SERVICES, INC. 2	FACILITY NUMBER: 455002481
	VISIT DATE: 08/16/2024

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

Care and supervision: staff did not seek medical attention for the resident in a timely manner.
On 3-14-24 the client fell when returning home from day program around 1400 hours. POA reported being contacted by staff about 1500 hours. POA believes that five to twenty minutes is too long for notification when a client has a fall. Per the general event reports staff provided client with ice and helped elevate knee. Staff reported after about 30 minutes clients was still complaining of pain. Administrator (Admin.) reported arriving at the house approximately 1515 hours and called 911 within 30 minutes. Admin. and staff attempted to transfer client into the van but realized client was unable to assist. Staff reported not calling 911 right away as the client tried to stand twice. The hospital medical records indicated on 3-14-24 at approximately 1646 hours, dispatch received a phone call regarding a sick person. At approximately, 1659 hours, emergency medical services (EMS) arrived at the home. Records report the chief complaint was noted to be knee pain with a duration of time noted as two hours. Licensee reported the ambulance was contacted within 15 to 20 minutes after the clients fall.

LIC 9099 Unsubstantiated: Although the above allegations mentioned may have happened, or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, the findings are Unsubstantiated.

Illegal eviction.

Interviews were performed and records reviewed. During record review, number five on the admission agreement states the licensee/administrator or Far Northern Regional Center may terminate this agreement with at least thirty (30) calendar days advance notice to the resident and FNRC. Further review of the admission agreement, number eleven reports the client as ambulatory. It was reported on 3-14-24 the client fell leaving them non-ambulatory. The doctors report indicated the client had knee surgery on 3-26-24 leaving them non ambulatory for 6 to 7 weeks. On 3-27-24, facility staff received a call from POA advising staff that the client requires more care than realized and they would be bringing the client back to the facility. Staff completed a needs and services plan modification and forwarded a copy to LPA. It was determined by staff that they would not be able to provide adequate care due to the non-ambulatory status. A 30-day notice was served on 4-3-24 to the POA and a copy was forwarded to the licensing Program Analyst.

Continued on page 2 of 9099-C

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sarah Benson
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 59-AS-20240404101858

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: NEW VISION SERVICES, INC. 2	FACILITY NUMBER: 455002481
	VISIT DATE: 08/16/2024

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

Page 2.

It was reported the administrator worked with the regional center for new placement to meet the residents care needs. The regional center was able to find placement for the resident’s non-ambulatory status at a new facility, but the POA declined for the client to be place at the new facility .

LIC 9099 Unsubstantiated: Although the above allegations mentioned may have happened, or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, the findings are Unsubstantiated.

Care and supervision: residents care needs were not met.

On 3-14-24 the client was walking into the facility and fell in the entry way. Per the hospital’s medical records, the client sustained an acute left patella fracture. The client’s physician's report dated 10-31-23 indicated the client was a mild fall risk with an unstable left ankle. However, the client’s development evaluation report dated 2-15-24 indicated the client can walk alone at least twenty feet with good balance. Additionally, the clients far northern regional center individual program plan dated 2-15-24 did not indicate the client was considered a fall risk. Staff and client POA reported the client was not a fall risk prior to her fall on 3-14-24. On 6-5-24, Licensee, reported the client was not considered a fall risk. The licensee believes the mild fall risk note in client physicians reported dated, 10-31-23 was based off prior medical records.

No deficiencies cited. Exit interview conducted and a copy of the report was provided to administrators Evelyn Lander-Williams, Melissa Johnson Administrator.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sarah Benson
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3