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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455002490
Report Date: 03/29/2022
Date Signed: 04/01/2022 02:03:07 PM

Substantiated


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
12/23/2021 and conducted by Evaluator Misty Valencia
COMPLAINT CONTROL NUMBER: 25-AS-20211223102536
FACILITY NAME:NEW VISION SERVICES, INC. 6FACILITY NUMBER:
455002490
ADMINISTRATOR:TROY WATKINSFACILITY TYPE:
735
ADDRESS:6462 KIMBERLY DRIVETELEPHONE:
(916) 224-2206
CITY:REDDINGSTATE: CAZIP CODE:
96001
CAPACITY:4CENSUS: 4DATE:
03/29/2022
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Melissa Johnson, AdministratorTIME COMPLETED:
01:33 PM
ALLEGATION(S):
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Residential Facility is neglecting client’s toenails
INVESTIGATION FINDINGS:
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On 03/29/2022, Licensing Program Analyst (LPA) Misty Valencia and Shannon Diegoruales conducted an announced complaint investigation visit regarding the above allegation directed by the department. LPA met with Melissa Johnson, Administrator and explained the reason for the visit is to deliver complaint findings. Prior to initiating the visit, LPA 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; contacted Administrator and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical masks. Additionally, LPA was screened by staff at the front door.

Throughout the course of the investigation the department conducted interviews, reviewed documentation, and observed residents in care.

***see 9099-C for continuation***
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Misty Valencia
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2022
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-20211223102536
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: NEW VISION SERVICES, INC. 6
FACILITY NUMBER: 455002490
VISIT DATE: 03/29/2022
NARRATIVE
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Residential Facility is neglecting client’s toenails

LPA toured the facility, and during the visit LPA conducted interviews, During interviews with C1, LPAs observed C1 to look groomed, showered and in good health. LPA interviewed Five of Five (5 of 5) staff and four of four (4 of 4) clients. Interviews revealed that on 12/23/2021, C1 went to day program and had an accident so the day program staff had to change C1’s clothes and socks. When day staff took off C1s socks they noticed thick long toenails, but C1 did not complain about his toes hurting.

During today’s visit, records were reviewed, and LPA observed that per C1's Physician's Report, documented that C1 needed assistance with personal grooming. Facility did not to assist with C1’s personal hygiene and receive care from a podiatrist according to his specific need. Administrator stated that facility staff were providing C1 with hygiene assistance and assisting with C1s toenails once a month. Although facility continued to take C1 to get his nails debrided once a month, Podiatrist recommended that C1 have his toenails debrided periodically and to see podiatrist every six (6) months. C1 may need to get nails trimmed more than once a month to meet his specific need. Witness provided a picture showing growth of resident's toenails and LPA observed from the photo that the toenails were long, thick and cutting into C1’s skin. Based on the information obtained the allegation is substantiated.

The following deficiencies were observed (see LIC 9099D) and cited from the California Code of Regulations, Title 22, and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties.

Exit interview conducted, report and appeal rights emailed to Administrator.

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Misty Valencia
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 25-AS-20211223102536
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: NEW VISION SERVICES, INC. 6
FACILITY NUMBER: 455002490
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/29/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/05/2022
Section Cited
CCR
85075(b)
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85075 Health- Related Services (b) The facility shall develop and implement a plan which ensures that assistance is provided to the clients in meeting their medical and dental needs.
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Licensee agrees to develop a plan to ensure that all residents receive appropriate medical/dental care in a timely manner.
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This requirement was not met as evidenced by: facility did not assist in C1s medical needs as neccesary causing C1 to have long thick toenails, which poses a potential health and safety risk to residents in care.
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Licensee agrees to provide an inservice to all staff as to how residents will be observed/monitored for changes in condition and hygiene needs to ensure that they receive appropriate medical/dental care when needed. Licensee agrees to send written plan and proof of in service to CCL by 04/05/2022
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Misty Valencia
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3