455002676-12-16-2021-25-AS-RLBN-C9X2R2-20211221163647

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 455002676
Report Date: 12/16/2021
Date Signed: 12/16/2021 11:59:37 AM

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
10/01/2021 and conducted by Evaluator Misty Valencia

COMPLAINT CONTROL NUMBER: 25-AS-20211001142259

FACILITY NAME:	WESTSIDE ASSISTED LIVING		FACILITY NUMBER:	455002676
ADMINISTRATOR:	ENEIX, AUDRA		FACILITY TYPE:	740
ADDRESS:	915 HALLMARK DR		TELEPHONE:	(530) 605-4041
CITY:	REDDING	STATE: CA	ZIP CODE:	96001
CAPACITY:	6	CENSUS: 5	DATE:	12/16/2021
		UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Maria Teibel, Direct Care Staff		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Personal Rights-cameras with audio in the facility

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 12/15//2021, Licensing Program Analyst (LPA) Misty Valencia conducted an unannounced complaint investigation visit to deliver findings regarding the above allegations directed by the department. LPA met with Maria Teibel, Direct Care Staff and explained the reason for the visit. 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.

continued on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Misty Valencia	TELEPHONE: (530) 895-5820
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2021

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-20211001142259

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: WESTSIDE ASSISTED LIVING	FACILITY NUMBER: 455002676
	VISIT DATE: 12/16/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

-cameras with audio in the facility

During interviews with Administrator, staff, resident and records reviewed, it was determined; Cameras with audio in the facility to be unsubstantiated. LPA toured the facility, and during the visit, LPA interviewed Six of Six (6 of 6) staff, who reported they have never had any issues or concerns regarding cameras with audio in the facility. LPA finds the allegation to be UNSUBSTANTIATED. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

There were no citations issued during today's visit, copy of report was given. An exit interview was conducted

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Misty Valencia	TELEPHONE: (530) 895-5820
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 2