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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455002744
Report Date: 09/10/2024
Date Signed: 09/10/2024 11:40:24 AM

Substantiated


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
07/02/2024 and conducted by Evaluator Farhaan Sarangi
COMPLAINT CONTROL NUMBER: 59-AS-20240702161201
FACILITY NAME:HORIZON ET AL, LLCFACILITY NUMBER:
455002744
ADMINISTRATOR:LAWSON, STEPHENFACILITY TYPE:
740
ADDRESS:1023 GREENBRIAR CTTELEPHONE:
(530) 227-5020
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY:6CENSUS: 3DATE:
09/10/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Administrator, Stephen Lawson
Licensee, Colleen Lawson		TIME COMPLETED:
10:30 AM
ALLEGATION(S):
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facility room used for staff not cleared
INVESTIGATION FINDINGS:
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On September 10, 2024 at approximately 10:00 AM, Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced for the purpose of amending a report and delivering a finding on a complaint that was generated on July 2, 2024. Upon arrival, LPA was greeted at the door by Administrator, Stephen Lawson and was granted access into the facility. Licensee arrived 30 minutes later.

During the course of the investigation, LPA reviewed facility records, resident records, interviewed staff, residents in care and toured the facility on July 9, 2024, July 16, 2024, July 29, 2024, August 20, 2024 and September 10, 2024.

Complaint alleges that facility room used for staff not cleared. On July 16, 2024, at approximately 01:00 PM, LPA Sarangi conducted a Case Management-Other inspection and conducted a tour of the room located behind the laundry room and observed a bed inside the room which was not observed on the original STD 850 Fire Safety Inspection Request Report dated for January 10, 2020. (Report continued on LIC 9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Farhaan Sarangi
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.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 59-AS-20240702161201
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: HORIZON ET AL, LLC
FACILITY NUMBER: 455002744
VISIT DATE: 09/10/2024
NARRATIVE
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LPA advised the Licensee on said day that the room would need to be inspected by the Local Fire Jurisdiction to ensure that the bedroom can accommodate a staff member.

On July 30, 2024, the Local Fire Jurisdiction inspected the bedroom and notated on the STD 850 Fire Safety Inspection Request Report that the room is not to be used for sleeping (See LIC 9099D). Furthermore, the STD 850 Fire Safety Inspection Request Report summarized that the room does not meet requirements for a bedroom. LPA conducted a tour of the facility on August 20, 2024 and September 10, 2024, and found that the room is no longer being utilized as a bedroom for staff. The room was observed to be utilized for storage related purposes.

Deficiencies cited from the California Code of Regulations, Title 22, Division 6, Chapter 8 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties. Exit interview was conducted, and a copy of this report was signed and given to the Licensee.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Farhaan Sarangi
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
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 59-AS-20240702161201
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: HORIZON ET AL, LLC
FACILITY NUMBER: 455002744
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/11/2024
Section Cited
CCR
87202(a)
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87202(a) Fire Clearance

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal.

This requirement was not met as evidenced by:
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Facility to submit an LIC 9098 understanding of the regulation. In addition, Licensee shall submit a plan for future compliance.


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Based on observation of the room located behind the laundry room on July 16, 2024, LPA observed a bed inside the room which was not observed on the original STD 850. The Local Fire Jurisdiction inspected the bedroom and notated on the STD Fire Safety Inspection Request Report that the room is not to be used for sleeping. Furthermore, the STD 850 Fire Safety Inspection Request Report summarized that the room does not meet requirements for a bedroom. This is an immediate health, safety and personal rights risk to the residents in care.
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POC Due Date: September 11, 2024
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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: Lauren Crocker
LICENSING EVALUATOR NAME: Farhaan Sarangi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3