525002968-1-28-2025-59-AS-LCRR-DDJPT5-20250203103521

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 525002968
Report Date: 01/28/2025
Date Signed: 01/28/2025 10:54:33 AM

Unsubstantiated

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
12/11/2024 and conducted by Evaluator Rebecca Knight

COMPLAINT CONTROL NUMBER: 59-AS-20241211085805

FACILITY NAME:	LIBERTY		FACILITY NUMBER:	525002968
ADMINISTRATOR:	PHELPS, ASHLEY		FACILITY TYPE:	735
ADDRESS:	22891 OAK VIEW DRIVE		TELEPHONE:	(530) 200-2909
CITY:	RED BLUFF	STATE: CA	ZIP CODE:	96080
CAPACITY:	4	CENSUS: 4	DATE:	01/28/2025
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Michael Collin Harris - administrator		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Staff did not ensure client's podiatry care needs were properly met. - UNSUBSTANTIATED
Staff did not treat clients in care with respect. - UNSUBSTANTIATED

INVESTIGATION FINDINGS:

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01/28/2025 10:15 AM Licensing Program Analyst (LPAs) Rebecca Knight and Kayla Adkison made an unannounced visit to the facility and met with administrator Michael Collin Harris. The purpose of this visit was to deliver the results of a complaint investigation.

During the course of the investigation LPA conducted interviews and reviewed the following documents: Admission agreement, IPP, LIC600 Physicians Report, Care Plan, care notes for 1 client, staff list with telephone numbers.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

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-20241211085805

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: LIBERTY	FACILITY NUMBER: 525002968
	VISIT DATE: 01/28/2025

NARRATIVE

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Staff did not ensure client's podiatry care needs were properly met. - UNSUBSTANTIATED

It was alleged that management do not promptly make appointments for Client 1 (C1) to get their toenails clipped/trimmed.

C1’s Physicians Report states that C1 requires assistance with some of their personal needs such as bathing. C1 is able to dress and feed themselves. C1’s admission agreement states that C1 is assisted with bathing and personal needs, as required. LPA reviewed care notes dated 12/17/2025 which state spoke with C1’s family member who stated they had talked to C1’s primary doctor about the fungus on C1’s big toes. C1’s primary doctor wanted to prescribe C1 with a medication but C1’s family decided against it. C1 had an appointment with primary on January 2, 2025, and family stated staff can speak with the doctor about C1’s feet at that appointment.

Staff interviews revealed that C1 doesn’t like people touching their feet. Family has been aware if this, the facility has been trying to get C1 in with their family member at the doctor. When C1 goes home to visit their family a family member trims their toenails. The facility has been trying to get C1 into see a podiatrist to obtain treatment for a fungal infection.

Licensee stated when C1 was initially admitted, the family informed staff that no one has ever been able to cut C1’s nails other than C1’s mother and their mother would continue to do so. Family explained they are not comfortable with any type of chemical medication or topical.

Licensee stated On 11/29/2024 the administrator spoke to family member (conservator) who reminded that C1 does not do well with podiatry and they did not want any medicated ointment used on C1 due to risk from chemicals. Family did see the point in having it looked at but that C1’s primary could look at it, appointment was scheduled for 01/06/2025.

Licensee stated Family did approve a non-medicated over the counter cream, but also stated that it would not work because the fungus is under the nail bed. Family member stated they would look at it and trim C1's toenails on their next visit.

It was determined that on 11/29/2024 administrator spoke with C1’s conservator about the need for C1 to see a podiatrist. That day an appointment was made for C1 to see their podiatrist on 01/06/2025. This allegation is unsubstantiated.

Continued on LIC9099-C

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

LIC9099 (FAS) - (06/04)

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Control Number 59-AS-20241211085805

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: LIBERTY	FACILITY NUMBER: 525002968
	VISIT DATE: 01/28/2025

NARRATIVE

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Staff did not treat clients in care with respect. – UNSUBSTANTIATED

It was alleged that staff are extremely cruel and neglectful of the residents during the NOC shift.

During staff interviews it was learned that there is one NOC staff who has a loud voice but they have never been verbally abusive to the clients.

It was determined that no specific examples of staff being cruel or neglectful were provided in the complaint. Complainant did not return LPA’s call when LPA attempted to gather more details. 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.

No deficiencies cited. Exit interview conducted and a copy of the report was provided to administrator Michael Collin Harris.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

LIC9099 (FAS) - (06/04)

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