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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455002792
Report Date: 10/25/2023
Date Signed: 10/25/2023 01:40:07 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
05/02/2023 and conducted by Evaluator Sarah Benson
COMPLAINT CONTROL NUMBER: 59-AS-20230502160905
FACILITY NAME:DIAMOND RESIDENTIALFACILITY NUMBER:
455002792
ADMINISTRATOR:LEAK, RANDYFACILITY TYPE:
735
ADDRESS:16981 CATALINA WAYTELEPHONE:
(530) 200-0701
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY:4CENSUS: 4DATE:
10/25/2023
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Rebecca CulverTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Personal Rights - A variety of activities are not being provided, as required.
INVESTIGATION FINDINGS:
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Personal rights- A variety of activities are not being provided, as required.

On 10-25-23 Sarah Benson, Licensing Program Analyst (LPA) arrived at the facility unannounced to deliver final findings regarding a complaint that was received on 05-02-23. LPA Benson met with Rebecca Culver, Administrator, and explained the purpose of the visit.

During the interview process, the administrator, three staff persons, four residents and the regional center service coordinator were interviewed. Documents were received and reviewed to include the client list, staff list with telephone number, Client Admission Agreements, Individual Program Plans (IPPs) and Personal and Incidental (P&I) funds.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sarah Benson
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2023
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 3
Control Number 59-AS-20230502160905
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: DIAMOND RESIDENTIAL
FACILITY NUMBER: 455002792
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/08/2023
Section Cited
CCR
85079(a)(2)(c)
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85079((a)(2)(c) Activities - The licensee shall ensure that planned activities... provided for the clients: Physical activities... games, sports, and exercise. The licensee shall ensure that clients are given the opportunity to attend and participate in community activities...This requirement is not met as evidenced by:
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The administrator agrees to develop a planned acitivity program, encouraging all reaidents to contribute to the planning, preparation, and evaluation of the activities.
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Based on observation and interviews conducted, the administrator did not ensure that there is a planned activity program that includes a variety of actiities for the clients. This poses a potential health and safety risk to residents in care.
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Documentaion of the planned activity program shall be submitted to the licensing agency by 11-08-23
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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: Sarah Benson
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 59-AS-20230502160905
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: DIAMOND RESIDENTIAL
FACILITY NUMBER: 455002792
VISIT DATE: 10/25/2023
NARRATIVE
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Personal Rights -A variety of activities are not being provided, as required.

Personal Rights - A variety of activities are not being provided, as required.
During the investigative process it was reported that staff were not providing a variety of activities for the clients. During the time of March-May 2023, the administrator provided a calendar which indicated various activities on weekends to include going to McDonalds, Walmart, Dutch Brothers, Cupcake and Sweets, Kaleidoscope Coffee, Denny’s, Goodwill, and the Salvation Army. Upon review of the client’s Personal and Incidental (P&I) money log, it indicated that the client’s pay with their P&I money for these weekend Saturday events. Per the regulations, the licensee is to provide a more extensive list of activities to include games, sports, exercise, community service activities, community events to include concerts, tours, dances, celebrations of special events, etc. The clients have not been provided with a variety of activities as required by the regulations.

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.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sarah Benson
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3