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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455000800
Report Date: 06/09/2021
Date Signed: 06/09/2021 12:51:01 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:RHODES RESIDENTIAL SERVICEFACILITY NUMBER:
455000800
ADMINISTRATOR:RHODES, ANGELAFACILITY TYPE:
735
ADDRESS:7079 PIT ROADTELEPHONE:
(530) 247-6912
CITY:REDDINGSTATE: CAZIP CODE:
96001
CAPACITY:4CENSUS: 4DATE:
06/09/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Trisha SteeleTIME COMPLETED:
01:00 PM
NARRATIVE
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06/09/2021 at 11:45 AM Licensing Program Analyst (LPA) Jaclyn Avila arrived at the facility unannounced to conduct a case management concerning an incident report that was submitted to licensing on 5/20/21. LPA met with administrator Trisha Steele at 3963 RIVERVIEW DRIVE, Redding (Sister Facility) and explained the purpose of the visit. 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: N-95 Mask.

On 5/20/21, it was reported via incident report to Community Care Licensing (CCL) that on 5/18/21, the administrator determined medications were missing from a PRN bubble pack and Staff 1 (S1) was on shift. S1 was terminated on 5/18/21 at which time he admitted he took the Lorazapam tablets out of PRN packs belonging to clients. Although medication was stolen, clients did not miss dosages.

Administrator reported this incident to law enforcement (Redding Police Department). Administrator has scheduled and arranged staff training for all staff on 5/25/21 on how to identify drug use on the job.

The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted and appeal rights provided.
SUPERVISOR'S NAME: Rayna L BrysonTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaclyn AvilaTELEPHONE: (530) 895-4275
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: RHODES RESIDENTIAL SERVICE
FACILITY NUMBER: 455000800
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/10/2021
Section Cited

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1569.58 (a) (2) -Conduct Inimical -(a) The department may prohibit any person from being a licensee...and may further prohibit any licensee from...continuing the employment of, or allowing in a licensed facility, or allowing contact with clients of a licensed facility by, any employee who has done any of the following:(2) Engaged in conduct that is
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inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility.This requirement was not met as evidenced by: documentation. Administrator and facility staff failed to keep client medication safe. This poses an immediate risk to residents in care
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Type A
06/10/2021
Section Cited

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80072(a)(2)-Personal Rights-(a)Each client shall have personal rights which include, but are not limited to, the following:To be accorded safe, healthful and comfortable accommodations...
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This requirement was not met as evidenced by: documentation. Administrator and facility staff failed to keep client medication safe. This poses an immediate risk to clients in care
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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.
SUPERVISOR'S NAME: Rayna L BrysonTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaclyn AvilaTELEPHONE: (530) 895-4275
LICENSING EVALUATOR SIGNATURE:
DATE: 06/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/09/2021
LIC809 (FAS) - (06/04)
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