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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002486
Report Date: 02/07/2022
Date Signed: 02/10/2022 09:23:43 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:VETERANS HOME OF CALIFORNIA-REDDINGFACILITY NUMBER:
455002486
ADMINISTRATOR:EISZELE, PAMELAFACILITY TYPE:
740
ADDRESS:3400 KNIGHTON ROADTELEPHONE:
(530) 224-3300
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY:93CENSUS: 88DATE:
02/07/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Kristi Munson and Ron ThoresonTIME COMPLETED:
02:45 PM
NARRATIVE
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On Febuary 7, 2022, a Non-Compliance Conference was conducted on this day in the Sacramento North Regional Office via Webex, due to COVID 19 precautions. The purpose of this Non-Compliance Conference meeting was to discuss the citations that were issued on 1/20/2022 regarding a COVID-19 outbreak at the facility. Present in the meeting was licensing Program Manager (LPM) Laura Munoz in lieu of Regional Manager (RM) Alycia Berryman, LPM Troy Ordonez, LPA Misty Valencia, and LPA Shannon Diegoruelas, Lori Templeton, Administrator,Pam Eiszele, Administrator,Ron Thoreson, AHH,Rebecca Alexander , Administrator Assistant,Dixie Pridmor, Infection Control officer, Kristi Munson, Quality Assurance,Beth Muszynski, Asst Deputy Secretary,Dan Maullam, Chief Counsel,Tina Ramirez, Human Resources Director and Manny Dumangas, Infection Control officer.

The Non-Compliance Conference process was explained during this meeting to include the Covid 19 staff protocols. Issues discussed during the meeting were :

-On 12/17/2021, the Sacramento North Regional Office received a report of a new COVID-19 positive staff person via email.

-Infection control: facility staff working with symptoms

-Not adhering to the Public Health Order (testing visitors, record keeping)

-COVID-19 staff screening - clarification regarding following the strictest guidance


continued on 809-C
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Misty ValenciaTELEPHONE: (530) 895-5820
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: VETERANS HOME OF CALIFORNIA-REDDING
FACILITY NUMBER: 455002486
VISIT DATE: 02/07/2022
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The facility has stated they will do the following to achieve continued and substantial compliance:
The Department would like the facility to submit the following by: 2/14/22

· A plan on how facility staff will be trained in required areas prior to completing duties:


· Plan should include - responsibility will be to conduct training, monitor training and document training.
· The Department may increase monitoring at your facility.
· Facility will comply with strictest guidance related to COVID-19
· Facility will report all COVID-19 positives within 24 hours by phone or fax, or email.
· Facility will provide updated mitigation plan
· Submit a Personel Report LIC 500
· Facility will updated staff screening documents that shows no symptoms within forty-eight (48) hours and not four(4) hours
Licensee agrees to complete required training for all care staff. The Licensee shall send a list detailing the date and topic of training.
· A progress report compliance meeting may be conducted at the end of the six month time period outlined by the Non-Compliance Conference.


Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies are being cited during this visit. An exit interview was conducted and a copy of this report was provided via email.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Misty ValenciaTELEPHONE: (530) 895-5820
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2022
LIC809 (FAS) - (06/04)
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