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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 525002362
Report Date: 10/28/2021
Date Signed: 10/28/2021 12:47:49 PM

Substantiated


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
06/18/2021 and conducted by Evaluator Rebecca Knight
COMPLAINT CONTROL NUMBER: 25-AS-20210618113627
FACILITY NAME:SAIL HOUSE, INC., THEFACILITY NUMBER:
525002362
ADMINISTRATOR:CAREY, CHRISFACILITY TYPE:
735
ADDRESS:21125 LUTHER ROADTELEPHONE:
(530) 527-5780
CITY:RED BLUFFSTATE: CAZIP CODE:
96080
CAPACITY:23CENSUS: 23DATE:
10/28/2021
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Micah Carey - administratorTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff do not wear masks or gloves.
INVESTIGATION FINDINGS:
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10/02/2021 2:00 PM Licensing Program Analyst (LPA) Rebecca Knight, made an unannounced visit to the facility and met with Micah Carey administrator for the facility. The purpose of this visit was to deliver the results of the complaint investigation of the above allegations. 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 Mask, gloves.

During the course of the investigation LPA interviewed 1 administrator, 5 care staff, and 4 clients. LPA obtained the following documents to investigate the above allegation:, pest control invoices, and staff list with contact information.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rayna L Bryson
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
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 3
Control Number 25-AS-20210618113627
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: SAIL HOUSE, INC., THE
FACILITY NUMBER: 525002362
VISIT DATE: 10/28/2021
NARRATIVE
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Allegation: Staff do not wear masks or gloves. - SUBSTANTIATED.

During LPA Knight’s visit to the facility on 8/12/2021 LPA observed 3 staff who were in the facility not wearing face masks. Staff are not required to wear gloves at all times in the facility.

Staff interviews revealed that all staff were wearing masks until 8/02/2021. Staff thought the California regulations and mask requirements had relaxed, so staff stopped wearing them. During this same visit on 8/12/2021 LPA Knight witnessed the administrator contact all staff via facility group chat and notified them that they are required to wear face masks at all times while in the facility. The administrator called a staff person and requested they purchase surgical masks for all staff and that staff person fulfilled this request. All staff in the facility immediately put on masks as soon as LPA Knight informed them of the regulation.

Based on observation, interviews and evidence obtained, the preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22), is being cited on the attached LIC9099D. Appeal rights were provided, report was emailed to the administrator.

SUPERVISORS NAME: Rayna L Bryson
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 25-AS-20210618113627
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: SAIL HOUSE, INC., THE
FACILITY NUMBER: 525002362
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/28/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/28/2021
Section Cited
CCR
80072(a)(2)
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Personal Rights. (a) Each client shall have personal rights which include, but are not limited to, the following: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement was not met as evidenced by:
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During this same visit on 8/12/2021 LPA Knight witnessed the administrator contact all staff via facility group chat and notify them that they are required to wear face masks at all times while in the facility. The administrator called a staff person and requested they purchase surgical masks for all staff and that staff person fulfilled this request. All staff in the facility immediately put on masks as soon as LPA Knight informed them of the regulation.
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Based on interviews and observation, LPA observed 3 staff not wearing masks in the facility on 8/12/2021. All staff stopped wearing face masks while in the facility on 8/02/2021 because they thought California regulations and mask requirements had relaxed which poses an immediate health and safety risk to residents in care.
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This deficiency was corrected during LPA visit on 8/12/2021.
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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: Rayna L Bryson
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3