455002636-12-6-2022-25-AS-APEZ-CM2NTX-20221212094529

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 455002636
Report Date: 12/06/2022
Date Signed: 12/06/2022 08:39:44 AM

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
08/18/2022 and conducted by Evaluator Donna Gurriere

COMPLAINT CONTROL NUMBER: 25-AS-20220818160631

FACILITY NAME:	NEW VISION SERVICES SENIOR LIVING		FACILITY NUMBER:	455002636
ADMINISTRATOR:	WILLIAMS, EVELYN LANDER		FACILITY TYPE:	740
ADDRESS:	1850 LAKE BLVD		TELEPHONE:	(916) 224-2206
CITY:	REDDING	STATE: CA	ZIP CODE:	96003
CAPACITY:	24	CENSUS: 17	DATE:	12/06/2022
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	AMBER GREENE		TIME COMPLETED:	09:15 AM

ALLEGATION(S):

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Personal Rights/Sexual Abuse.
Staff gave resident unknown medication.

INVESTIGATION FINDINGS:

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Donna Gurriere, Licensing Program Analyst was in contact and met with Amber Greene, Administrator. Allegation is in regard to Personal Rights/Sexual Abuse and Staff gave resident unknown medication.

LPA Gurriere completed the required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID 19 infection to affirm no COVID-19 related symptoms. The administrator/staff person was contacted to complete a facility risk assessment. LPA Gurriere ensured that hand sanitizer was applied before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 mask. Additionally, LPA Gurriere was screened by a staff person upon entering the facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR NAME: Donna Gurriere	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 25-AS-20220818160631

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 SENIOR LIVING	FACILITY NUMBER: 455002636
	VISIT DATE: 12/06/2022

NARRATIVE

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Personal Rights/Sexual Abuse.
During the investigation, a resident, staff person, resident’s sister and the licensees Kenneth and Evelyn Williams were interviewed. Documents obtained for the investigation included Physician’s Report, Admission Agreement, Individual Program Plan (IPP), register of client names, several incident reports, Pre-Assessment and Centrally Stored Medications Document.

During the interview process, it was reported that the resident (Resident 1) made inappropriate un-welcomed “passes” aimed at a male caregiver. It was reported that the resident is known to have “hallucinations” and “fantasies.” It was indicated that the resident was untruthful, and it was stated that the resident has a “vivid imagination.” The IPP states that the resident “engages in sexually inappropriate advances.” No actionable evidence was gathered during the investigation.

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

Staff gave resident unknown medication.
During the investigation, a resident, staff person, resident’s sister and the licensees Kenneth and Evelyn Williams were interviewed. Documents obtained for the investigation included Physician’s Report, Admission Agreement, Individual Program Plan (IPP), register of client names, several incident reports, Pre-Assessment and Centrally Stored Medications Document.

During the interview process, it was reported that the resident (Resident 1) was given an unknown medication. During the interview with the resident, she could not clearly articulate what happened, as the resident is developmentally disabled. Several persons stated that the resident tends to hallucinate and fantasizes when relating to staff of the opposite sex. Staff submitted a lab report that indicated that the resident only had medications in her system that she was prescribed. No actionable evidence was gathered during the investigation.

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

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR NAME: Donna Gurriere	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022

LIC9099 (FAS) - (06/04)

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