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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 525000804
Report Date: 12/10/2024
Date Signed: 12/10/2024 12:29:33 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
10/17/2024 and conducted by Evaluator Rebecca Knight
COMPLAINT CONTROL NUMBER: 59-AS-20241017144846
FACILITY NAME:NORTH VALLEY SERVICES - BEHAVIOR MANAGEMENT PGRMFACILITY NUMBER:
525000804
ADMINISTRATOR:CHAVEZ, ESPERANZAFACILITY TYPE:
775
ADDRESS:13315 BAKER RDTELEPHONE:
(530) 528-1083
CITY:RED BLUFFSTATE: CAZIP CODE:
96080
CAPACITY:80CENSUS: 40DATE:
12/10/2024
UNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Esperanza Chavez - administratorTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Licensee does not ensure facility is kept free of pests. - SUBSTANTIATED
Licensee does not ensure grounds are properly maintained in good repair. – SUBSTANTIATED
Licensee does not ensure transport vehicles are kept in safe working conditions. - SUBSTANTIATED
INVESTIGATION FINDINGS:
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12/10/2024 10:30 AM Licensing Program Analyst (LPA) Rebecca Knight, made an unannounced visit to the facility and met with administrator Esperanza Chavez. The purpose of this visit was to deliver the results of a complaint investigation.

During the course of the investigation LPA interviewed administrators and staff. LPA reviewed the following documents: Monthly vehicle inspection reports, pest control service slips, staff list with telephone numbers, staff schedules.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
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 8
Control Number 59-AS-20241017144846
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: NORTH VALLEY SERVICES - BEHAVIOR MANAGEMENT PGRM
FACILITY NUMBER: 525000804
VISIT DATE: 12/10/2024
NARRATIVE
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Licensee does not ensure facility is kept free of pests. – SUBSTANTIATED

It was reported that there is rat feces all over the facility especially where the clients keep their food.

On 10/21/2024 LPA toured the facility and observed rat feces on top of the lockers in the cantina.

LPA reviewed an email dated 07/29/2024, title “Work order for mice problem” that states that a local pest control company had been scheduled to service the facility. LPA reviewed service slips from the local pest control company. The service slips show that the company visited the facility on 05/02/2024, 06/04/2024, 07/30/2024, 08/01/2024, 09/03/2024, an additional slip is missing a service date.

Staff stated they had seen rat droppings in the cantina but they thought the facility had taken care of it.

Administrator stated they submitted a work order for pest control on 7/23/24. They haven’t had any sightings since.

Based on LPA observation although the facility has hired a pest control company there is still an issue with rodents in the facility. This allegation is substantiated.

Continued on LIC9099-C

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 8
Control Number 59-AS-20241017144846
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: NORTH VALLEY SERVICES - BEHAVIOR MANAGEMENT PGRM
FACILITY NUMBER: 525000804
VISIT DATE: 12/10/2024
NARRATIVE
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Licensee does not ensure grounds are properly maintained in good repair. - SUBSTANTIATED

It was reported that there are cracks in the pavement of the facility.

On 10/21/2024 LPA toured the facility and observed multiple large cracks in the pavement in the patio area in between the office and activities room. Some of the cracks are painted bright yellow, some look like they have attempted to even the surface by grinding down the area.

Staff stated that no clients had ever tripped over the cracks in the pavement.

Administrator stated there are pavement cracks, they are all marked, the clients are all aware of the cracks in the pavement, no one has tripped on the cracks.

It was determined that there are multiple large cracks in the pavement in the patio area. Even though the clients are aware of the cracks there is a potential for clients to trip over the cracks. This allegation is substantiated.

Continued on LIC9099-C

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 8
Control Number 59-AS-20241017144846
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: NORTH VALLEY SERVICES - BEHAVIOR MANAGEMENT PGRM
FACILITY NUMBER: 525000804
VISIT DATE: 12/10/2024
NARRATIVE
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Licensee does not ensure transport vehicles are kept in safe working conditions. - SUBSTANTIATED

It was reported that not all the transport buses are safe, they don't all have working seat belts for the clients, none of AC units on the buses work.

When LPA visited the facility on 10/21/2024 and 10/29/2024 the vans were not at the facility and LPA could not inspect them.

LPA reviewed vehicle inspection reports for vehicles 52 and 56 for August 2024. Vehicle 52 for all dates the condition of vehicle is marked satisfactory. Dates 08/22/24 through 08/30/2024 it is noted that the wheelchair lift was not working. Vehicle 56 for all dates the condition of vehicle is marked satisfactory. Date 08/02/24 it is noted that the AC was not very cold in the afternoon and the clients were hot on the ride home.

Staff stated that the seatbelts all work on the transport buses. Staff stated one of the vans had some issue with the air so they didn’t use it when it was hot, stated it doesn’t feel like the air is very cold.

Administrator stated the facility has two commercial and one non-commercial van. They just all passed the CHP annual inspections. All of the seat belts work, all of the air conditioning works.

It was determined that vehicle 56 needs to have the air conditioning repaired / serviced due to not blowing cold air on hot days. This allegation is substantiated.

Based on interviews, documents and evidence obtained during the investigation, the preponderance of evidence standard has been met, therefore, the allegations are found to be SUBSTANTIATED. California Code of Regulations, (Title 22), is being cited on the attached LIC9099D. Appeal rights were provided. Exit interview was conducted and the report was provided to administrator Esperanza Chavez.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 8
Control Number 59-AS-20241017144846
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: NORTH VALLEY SERVICES - BEHAVIOR MANAGEMENT PGRM
FACILITY NUMBER: 525000804
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/24/2024
Section Cited
CCR
82087(a)
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82087(a) Buildings and Grounds (a) The program site shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. This requirement is not met as evidenced by:
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Licensee agrees to contract with a pest control company who will ensure that the facility is clear of all rodents and their droppings. Licensee agrees to remove the area of the patio that has large cracks and pour new cement to ensure there are no cracks in the patio. Licensee agrees to submit signed contracts with the pest control company. Signed contract from construction contractor with start date of cement work to LPA. Additionally, licensee agrees to submit photographs of the tops of the lockers in the cantina to LPA by 12/24/2024. Photographs of the completed cement work to LPA as proof of correction.
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LPA observed rat feces on top of the lockers in the cantina and observed multiple large cracks in the pavement in the patio area in between the office and activities room which poses a potential health and safety risk to clients in care.
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Photographs of cantina due 12/24/2024 and photographs of competed cement work date to be determined by contractor avaiability and weather.
Type B
12/24/2024
Section Cited
CCR
82074(c)
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82074(c) Transportation (c) Motor vehicles used to transport clients shall be maintained in a safe operating condition. This requirement is not met as evidenced by:
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Licensee agrees to have the air conditioning for vehicle 56 repaired/serviced as needed. Licensee shall submit service invoice to LPA as proof of correction.
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Based on document review and interviews vehicle 56 needs to have the air conditioning repaired / serviced due to not blowing cold air on hot days which poses a potential health and safety risk to clients in care.
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POC due 12/24/2024.
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: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 8
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
10/17/2024 and conducted by Evaluator Rebecca Knight
COMPLAINT CONTROL NUMBER: 59-AS-20241017144846

FACILITY NAME:NORTH VALLEY SERVICES - BEHAVIOR MANAGEMENT PGRMFACILITY NUMBER:
525000804
ADMINISTRATOR:CHAVEZ, ESPERANZAFACILITY TYPE:
775
ADDRESS:13315 BAKER RDTELEPHONE:
(530) 528-1083
CITY:RED BLUFFSTATE: CAZIP CODE:
96080
CAPACITY:80CENSUS: DATE:
12/10/2024
UNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Esperanza Chavez - administratorTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff does not ensure facility is kept in clean sanitary conditions. - UNSUBSTANTIATED
Licensee does not ensure bathrooms are kept in good repair. - UNSUBSTANTIATED
Facility is operating out of ratio. - UNSUBSTANTIATED
INVESTIGATION FINDINGS:
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Staff does not ensure facility is kept in clean sanitary conditions. - UNSUBSTANTIATED
No additional examples of the facility not being clean or sanitary were included in the complaint.
During LPA’s tour of the facility on 10/21/2024 there were no additional observations of unsanitary conditions in the facility.
This allegation is unsubstantiated. LPA is issuing a Buildings and Grounds citation for pest control and cracks in pavement that both fall under the clean, safe and sanitary regulation.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 6 of 8
Control Number 59-AS-20241017144846
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: NORTH VALLEY SERVICES - BEHAVIOR MANAGEMENT PGRM
FACILITY NUMBER: 525000804
VISIT DATE: 12/10/2024
NARRATIVE
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Licensee does not ensure bathrooms are kept in good repair. - UNSUBSTANTIATED

It was reported that the toilets in the bathrooms constantly get backed up and overflow onto the floor.

LPA toured the facility and observed all toilets free from obstruction or back up and functioning properly when flushed.

All staff stated that the toilets get clogged because some clients stuff things (paper towels, clothing) in the toilets and as a result the toilets clog. Staff states this is a behavior, not a plumbing issue.

Administrator stated We have clients who do this behavioral, they put things down the toilets. I have maintenance reports that they come in and fix it.



It was determined that the toilets are functioning properly. Occasionally some clients have behaviors and stuff items in the toilets causing them to clog. This allegation is unsubstantiated.

Continued on LIC9099-C

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
LIC9099 (FAS) - (06/04)
Page: 7 of 8
Control Number 59-AS-20241017144846
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: NORTH VALLEY SERVICES - BEHAVIOR MANAGEMENT PGRM
FACILITY NUMBER: 525000804
VISIT DATE: 12/10/2024
NARRATIVE
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Facility is operating out of ratio. - UNSUBSTANTIATED

It was reported that the facility is constantly out of ratio for staff to clients, there will be 5 or more clients to one staff.

LPA reviewed staffing schedules for September and October 2024. All days had between 10 to 13 staff working, the average number of staff working is 12 per day.

Staff stated when they go on big outings, they average about nine clients with three staff. For a smaller outing it would be 7 clients and 2 staff.

Administrator stated they do a one staff to three clients ratio but sometimes when staff calls in the administrator and assistant administrator step in to help. Sometimes there are 2 staff to 10 clients but we would both be out on the floor and bring it to 4 staff to 10 clients.

This allegation is unsubstantiated.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are UNSUBSTANTIATED.

An exit interview was conducted. A copy of the report was provided to administrator Esperanza Chavez.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
LIC9099 (FAS) - (06/04)
Page: 8 of 8