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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455002787
Report Date: 06/18/2024
Date Signed: 06/18/2024 10:02:50 AM

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
04/03/2024 and conducted by Evaluator Donna Gurriere
COMPLAINT CONTROL NUMBER: 59-AS-20240403101714
FACILITY NAME:SIERRA OAKS OF REDDINGFACILITY NUMBER:
455002787
ADMINISTRATOR:BOBAN, KRISTINEFACILITY TYPE:
740
ADDRESS:1520 COLLYER DR.TELEPHONE:
(530) 241-5100
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY:113CENSUS: 74DATE:
06/18/2024
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:ANNIE CLAYTONTIME COMPLETED:
10:10 AM
ALLEGATION(S):
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Staff are not mitigating the spread of scabies in the facility.
INVESTIGATION FINDINGS:
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On 06/18/24 Donna Gurriere, Licensing Program Analyst (LPA) arrived at the facility unannounced to deliver final findings regarding a complaint that was received on 04/03/24. LPA Gurriere met with Annie Clayton, Resident Care Director and explained the purpose of the visit.

Staff are not mitigating the spread of scabies in the facility.

During the interview process, the administrator was interviewed, and she provided numerous documents regarding various diagnoses of the residents. It was reported that approximately 15 residents and three staff persons at the facility developed a type of rash. Diagnoses included dermatitis, rash, and eczema in which the physicians prescribed various types of cream, medication, and showering treatment. Clothing and bedding were sanitized throughout the facility. Two residents and a resident’s family member were diagnosed with scabies, which can spread with people you have contact with.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lauren CrockerTELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Donna GurriereTELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2024
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 59-AS-20240403101714
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: SIERRA OAKS OF REDDING
FACILITY NUMBER: 455002787
VISIT DATE: 06/18/2024
NARRATIVE
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Based on investigation observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, (Title 22), is cited on the attached LIC 9099D.

Appeal Rights were explained and provided to the facility representative listed above and an exit interview was conducted. If any of the cited deficiencies are not corrected by the noted due date, civil penalties may be assessed.

SUPERVISOR'S NAME: Lauren CrockerTELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Donna GurriereTELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 59-AS-20240403101714
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: SIERRA OAKS OF REDDING
FACILITY NUMBER: 455002787
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/25/2024
Section Cited
CCR
87468.1(a)(2)
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Personal Rights - To be accorded safe, healthful, and comfortable accommodations, furnishings and equipment.
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The administrator agrees to submit a plan of correction to the licensing agency describing how this type of violation will be corrected.
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This requirement was not met as evidenced by the spread of scabies in the facility. This poses a potential risk to residents in care.
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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: Lauren CrockerTELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Donna GurriereTELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3