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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455002679
Report Date: 12/15/2020
Date Signed: 12/29/2020 02:05:26 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASETT RD., STE. 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/16/2020 and conducted by Evaluator Donna Gurriere
COMPLAINT CONTROL NUMBER: 25-AS-20200316085603
FACILITY NAME:HALLMARK HOUSEFACILITY NUMBER:
455002679
ADMINISTRATOR:OGRAM, KAYLAFACILITY TYPE:
740
ADDRESS:935 HALLMARK DRTELEPHONE:
(530) 243-3388
CITY:REDDINGSTATE: CAZIP CODE:
96001
CAPACITY:6CENSUS: 6DATE:
12/15/2020
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:GURMEEL SINGHTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Care and Supervision – A resident received an enema from a person that was not an appropriately skilled professional.
INVESTIGATION FINDINGS:
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Donna Gurriere, Licensing Program Analyst (LPA) was in contact with Gurmeel Singh, Licensee. A physical visit could not be made due to the orders in place regarding the Covid 19 Virus. It was alleged that there was a Care and Supervision violation in that a resident received an enema from a person that was not an appropriately skilled professional. Alleged incident happened in December 2019.

The licensee, administrator, nurse, numerous staff persons and the person that was not an appropriately skilled professional were interviewed. In addition, documents were collected and reviewed. During the interview process, it was determined that the non-appropriately skilled professional was a family member to the resident. It was reported that the family member did give an enema to the resident.

**continued**
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Rayna L BrysonTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Donna GurriereTELEPHONE: (530) 895-5033
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2020
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-20200316085603
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 COHASETT RD., STE. 170
CHICO, CA 95926
FACILITY NAME: HALLMARK HOUSE
FACILITY NUMBER: 455002679
VISIT DATE: 12/15/2020
NARRATIVE
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**continued**

The family member reported that she did not know that she could not give an enema to her family member. In part, the regulations state that enemas shall be permitted if administered according to physician’s orders by either the resident or an appropriately skilled professional.

Based on the evidence obtained, the preponderance of evidence standard has been met; therefore, the allegation is found to be Substantiated. California Code of Regulations (Title 22) is being cited on the attached LIC 9099D. Appeal rights are provided, and a closure interview was conducted.
SUPERVISOR'S NAME: Rayna L BrysonTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Donna GurriereTELEPHONE: (530) 895-5033
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 25-AS-20200316085603
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 COHASETT RD., STE. 170
CHICO, CA 95926

FACILITY NAME: HALLMARK HOUSE
FACILITY NUMBER: 455002679
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/15/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/22/2020
Section Cited
CCR
87622(a)(2)
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 Fecal Impaction Removal, Enemas, and/or Suppositories. The licensee shall be permitted to accept or retain a resident who requires manual fecal impaction removal, enemas, or use of suppositories under the following circumstances:
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The licensee agrees to put in place a policy that reflects the deficiency.

Licensee shall submit plan of correction to the licensing agency within one week.
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 Manual fecal impaction removal, enemas, and/or suppositories shall be permitted if administered according to physician's orders by either the resident or an appropriately skilled professional.
Based on interviews and review of documents, the licensee did not ensure that a physician's order was in place when a non-skilled professional administered an enema to a resident.
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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.
SUPERVISOR'S NAME: Rayna L BrysonTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Donna GurriereTELEPHONE: (530) 895-5033
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2020
LIC9099 (FAS) - (06/04)
Page: 3 of 3