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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455002663
Report Date: 08/14/2023
Date Signed: 08/14/2023 02:47:10 PM

Substantiated


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
08/04/2023 and conducted by Evaluator Donna Gurriere
COMPLAINT CONTROL NUMBER: 59-AS-20230804113841
FACILITY NAME:CURTIS HOMESFACILITY NUMBER:
455002663
ADMINISTRATOR:SCHWARTZ, HEATHERFACILITY TYPE:
735
ADDRESS:5038 HUNTINGTON DRIVETELEPHONE:
(530) 364-2905
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY:4CENSUS: 3DATE:
08/14/2023
UNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:JACOBB NUSS`TIME COMPLETED:
10:40 AM
ALLEGATION(S):
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Staff did not take measures to keep the facility free of insects.
INVESTIGATION FINDINGS:
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On 08/14/23 Donna Gurriere and Jaynae Boyles, Licensing Program Analysts (LPAs) arrived at the facility unannounced to discuss the above mentioned allegation. LPAs met with Jacobb Nuss, Administrator and explained the purpose of the visit.

Upon arrival at the facility, it was stated that the pest control person was just at the facility to spray indoors for insects/bed bugs. It was noted that this is the first attempt to get rid of the insects and that the pest control person will come back again to check and possibly spray a second time.

Based on investigation and interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, (Title 22), is being cited on the attached LIC 9099D.

Appeal Rights provided.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Donna Gurriere
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2023
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 59-AS-20230804113841
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: CURTIS HOMES
FACILITY NUMBER: 455002663
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/21/2023
Section Cited
CCR
80087(a)(1)
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Buildings and Grounds - The licensee shall take measures to keep the facility free of flies and other insects.
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The administrator agrees to submit a plan of correction to the licensing agency advising how this type of deficiency will be avoided in the future.
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This requirement was not met as evidenced by: Based on an interview with the administrator and physical plant observation, the licensee did not ensure that the facility was free of insects.
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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: Lauren Crocker
LICENSING EVALUATOR NAME: Donna Gurriere
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2