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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455002486
Report Date: 03/30/2022
Date Signed: 04/28/2022 02:43:52 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
02/08/2022 and conducted by Evaluator Shannon Diegoruelas
PUBLIC
COMPLAINT CONTROL NUMBER: 25-AS-20220208083000
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: 84DATE:
03/30/2022
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Pamela Eiszele AdministratorTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Facility put substance in resident's beverage
INVESTIGATION FINDINGS:
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 ***AMENDED***

This report is being amended from confidential to public. This is the only change to the report.

Licensing Program Analyst's (LPA's) Shannon Diegoruelas and Misty Valencia conducted an unannounced complaint visit and met with Pamela Eiszele, Administrator to deliver investigation findings. Prior to initiating the visit, LPA's completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA's ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical masks. Additionally, LPA's was screened by staff at the front door.



Continued on 9099C
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4700
LICENSING EVALUATOR NAME: Shannon DiegoruelasTELEPHONE: (530) 282-2393
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022
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 2
Control Number 25-AS-20220208083000
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 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: VETERANS HOME OF CALIFORNIA-REDDING
FACILITY NUMBER: 455002486
VISIT DATE: 03/30/2022
NARRATIVE
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The Department finds from interviewing the psychologist and his records review dated 10/25/21, 11/10/21, and 02/10/22 that R1 is diagnosed with:

*Severe personality disorder
*Borderline personality disorder traits
*Maladaptive personality traits
*Paranoia psychosis
*Delusional ideation/thoughts

It was reported by the psychologist that R1 was having a paranoia episode, believing someone put something in his water. It was determined through other interviews with Administrator, staff, and residents that eight of eight (8 of 8) staff and four of five (4 of 5) residents reported they have never heard of or witnessed any issues regarding substances being put into resident's beverages.

LPA finds allegation to be without merit or cause.

As a result of this investigation, LPA finds allegation to be (U) Unfounded - A finding that the complaint is Unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

An exit interview was conducted and copied of report was emailed to Administrator
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4700
LICENSING EVALUATOR NAME: Shannon DiegoruelasTELEPHONE: (530) 282-2393
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2