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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 525002755
Report Date: 09/10/2024
Date Signed: 09/10/2024 01:39:15 PM


Document Has Been Signed on 09/10/2024 01:39 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:LASSEN HOUSE SENIOR LIVINGFACILITY NUMBER:
525002755
ADMINISTRATOR:BRASWELL, NICOLEFACILITY TYPE:
740
ADDRESS:705 LUTHER RDTELEPHONE:
(530) 529-2900
CITY:RED BLUFFSTATE: CAZIP CODE:
96080
CAPACITY:86CENSUS: 57DATE:
09/10/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Nicole Braswell - administratorTIME COMPLETED:
01:30 PM
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09/10/2024 12:45 PM Licensing Program Analyst Rebecca Knight conducted an unannounced case management visit and met with administrator Nicole Braswell. Today’s visit is regarding incident reports that have been submitted by the facility regarding several falls that occurred at the facility over the past 6 weeks. The purpose of the visit was for LPA to have a discussion and provide resources.

Administrator stated the facility has increased their staffing in memory care, residents who are high fall risk have motion sensors in their rooms. Next month Butte Home Health is coming in to do a training on transfers, falls, and mobility at an all staff training.

In order to prevent this from occurring the facility will conduct a fall prevention training with all staff. Administrator will submit a copy of the facility’s fall prevention plan to LPA.

LPA referred administrator to ​​​​​​​​​StopFalls Sacramento Coalition for additional resources in fall prevention.

https://dhs.saccounty.gov/PUB/StopFallsSacramento/Pages/Stop-Falls-Sacramento-Coalition.aspx

No deficiencies were issued as a result of today’s visit. A copy of the report was provided to administrator Nicole Braswell.

SUPERVISOR'S NAME: Lauren CrockerTELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Rebecca KnightTELEPHONE: (530) 356-2841
LICENSING EVALUATOR SIGNATURE:
DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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