525002699-11-17-2021-25-AS-RLBN-C93T7R-20211124132912

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 525002699
Report Date: 11/17/2021
Date Signed: 11/17/2021 11:44:30 AM

Unsubstantiated

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
08/18/2021 and conducted by Evaluator Rebecca Knight

COMPLAINT CONTROL NUMBER: 25-AS-20210818163837

FACILITY NAME:	INSPIRED RESIDENTIAL WALKER RANCH		FACILITY NUMBER:	525002699
ADMINISTRATOR:	LEAK, RANDY		FACILITY TYPE:	735
ADDRESS:	12810 WALKER WAY		TELEPHONE:	(530) 200-2909
CITY:	RED BLUFF	STATE: CA	ZIP CODE:	96080
CAPACITY:	6	CENSUS: 6	DATE:	11/17/2021
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Randy Leak - Licensee/administrator		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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There are not enough staff to provide the level of care necessary to meet the client’s needs

The administrator is hardly ever on site at the facility

INVESTIGATION FINDINGS:

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11/17/2021 11:00 AM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility unannounced to conduct a complaint investigation. LPA met with licensee / administrator Randy Leak and explained the purpose of the visit was to deliver complaint investigation results for the above allegations. Prior to initiating the complaint investigation 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: N95 mask, gloves.

During the course of the investigation LPA interviewed 1 administrator, 8 staff, and 4 clients. LPA reviewed the following documents: Staff schedule for the month of August 2021, staff roster with telephone numbers, Individual Program Plans for clients, Facility Personnel Report Summary, LIC500 Personnel Report, and LIC308 Designation of Facility Responsibility.
Continued on LIC9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Rayna L Bryson
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 25-AS-20210818163837

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: INSPIRED RESIDENTIAL WALKER RANCH	FACILITY NUMBER: 525002699
	VISIT DATE: 11/17/2021

NARRATIVE

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There are not enough staff to provide the level of care necessary to meet the client’s needs – UNSUBSTANTIATED

It was alleged that There are not enough staff to provide the level of care necessary to meet the client’s needs.

Staff interviews revealed that there are 4 shifts that overlap throughout the day, and there are typically 2-3 staff per shift. 5 staff stated that staffing is sufficient, 2 staff stated that staffing is not sufficient, and 1 staff stated that staffing could be better. During client interviews it was learned that there are from 2-4 staff on duty for each shift. 3 clients stated their needs were being met, and 1 client stated their needs were sometimes being met.

Review of August 2021 staff schedule revealed that there are 2-3 staff per shift with 4 overlapping shifts.

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

Continued on LIC9099-C

SUPERVISORS NAME: Rayna L Bryson
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021

LIC9099 (FAS) - (06/04)

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Control Number 25-AS-20210818163837

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: INSPIRED RESIDENTIAL WALKER RANCH	FACILITY NUMBER: 525002699
	VISIT DATE: 11/17/2021

NARRATIVE

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The administrator is hardly ever on site at the facility – UNSUBSTANTIATED

It was alleged that the administrator is hardly ever on site at the facility

Staff interviews revealed that the administrator is on site at the facility sporadically throughout the week, and those visits are typically about 2 hours long. Client interviews revealed that the administrator it at the facility from two to six times per month. According to CCLD regulations for Adult Residential Facilities there is no required minimum amount of hours for the administrator to be on site at the facility, they must be on the premises the number of hours necessary to manage and administer the facility in compliance with applicable law and regulation. During client interviews 3 clients stated their needs were being met, and 1 client stated their needs were sometimes being met.

Document review of the Staff schedule for the month of August 2021 did not include the administrator, and the current LIC500 Personnel Report dated 01/16/2021 does not have the current administrator listed on the report. LPA Knight has requested the licensee submit an updated LIC500 Personnel Report and LIC308 Designation of Facility Responsibility to CCLD ASAP.

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

An exit interview was conducted. A copy of the report was emailed to facility administrator Randy Leak. No deficiencies were cited on today’s date.

SUPERVISORS NAME: Rayna L Bryson
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021

LIC9099 (FAS) - (06/04)

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