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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002932
Report Date: 10/15/2024
Date Signed: 10/15/2024 10:51:24 AM

Document Has Been Signed on 10/15/2024 10:51 AM - 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:HILLTOP SPRINGS SENIOR LIVINGFACILITY NUMBER:
455002932
ADMINISTRATOR/
DIRECTOR:		O'FARRELL, KEILAFACILITY TYPE:
740
ADDRESS:7 HILLTOP DRTELEPHONE:
(530) 395-1777
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY: 211CENSUS: 166DATE:
10/15/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Keila O'Farrell - administratorTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
NARRATIVE
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10/15/24 10:15 AM Licensing Program Analyst (LPA) Rebecca Knight conducted a case management visit to follow up on an issue that was reported to Donna Gurriere, LPA on 10/08/24. During a walk through of the memory care unit, LPA Gurriere spoke to a resident from the assisted living side of the facility who was visiting his wife in the memory care unit. LPA Gurriere asked the resident how he was doing, and he replied that everything was fine except for his wife’s laundry was not getting done. When asked why the laundry wasn’t getting done, he replied, “It was due to, well you know, the scabies outbreak.” He indicated that his wife was upset because her laundry was not getting done.

While gathering information of the scabies outbreak, LPA Gurriere was advised that at least two residents have scabies, and several other residents have a “rash.” It was reported that the residents that have a rash have not been diagnosed or been seen by a physician at this time.

Residents were observed mingling with one another, one care provider was giving pedicures to three residents, which could have increased the spread of scabies using the same utensils and gloves on each of the resident’s toes. Of concern is that the resident that was visiting his wife in memory care, could carry the scabies outbreak to the assisted living side of the facility where he resides. Facility staff included the care provider giving pedicures and one medication technician for 13 residents diagnosed with dementia.

Continued on LIC809-C
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE: DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/15/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: HILLTOP SPRINGS SENIOR LIVING
FACILITY NUMBER: 455002932
VISIT DATE: 10/15/2024
NARRATIVE
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The facility will be cited this date for the scabies outbreak and for not having enough staff to take the necessary precautions to prevent the spread of scabies. Sufficient staff were not present to ensure that the residents were taken to their physician for medical issues (rashes) and the laundry was not being completed to assist in the potential spread of scabies.

Based on investigation observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegations are found to be Substantiated. California Code of Regulations, (Title 22), is cited on the attached LIC809D.

Upon inspection of the facility’s compliance history, LPA determined that the licensee was issued a deficiency for the same violation within the past 12 months. As a result, a civil penalty was assessed in the amount of $250.00 on 10/15/2024 on the attached LIC421.

Appeal Rights were explained and provided to the facility representative listed above and an exit interview was conducted. If any of the cited deficiencies are not corrected by the noted due date, additional civil penalties may be assessed.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/15/2024 10:51 AM - It Cannot Be Edited


Created By: Rebecca Knight On 10/15/2024 at 08:27 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: HILLTOP SPRINGS SENIOR LIVING
FACILITY NUMBER: 455002932

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/29/2024
Section Cited
CCR
87468.1(a)(2)

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87468.1(a)(2) Personal Rights - To be accorded safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement was not met as evidenced by:
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The administrator agrees to submit a plan of correction to the licensing agency advising of the resident names of those that have scabies or a rash; a list of residents that need to see their physician and when, a step-by-step plan on how the facility will rectify the scabies outbreak and a plan to follow universal precautions as outlined in 87211(a)(1)(D).
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Based on an interviews and observations the Licensee/Administrator did not ensure that there was not a spread of scabies in the facility. This poses a potential health and safety risk to residents in care.
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Plan of correction is to be submitted to CCLD by 10/29/2024.
Type B
10/29/2024
Section Cited
CCR87411(a)

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87411(a) Personnel Requirements - General: Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required in Section 87608, Postural Supports. Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment, and grounds. The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services. This requirement was not met as evidenced by:
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Licensee/Administrator agrees to submit an understanding of the regulation. In addition, Licensee and Administrator shall hire additional staff in the Memory Care Unit and/or staff appropriately to meet the needs of the residents that the facility serves. Licensee/Administrator shall provide a statement on how they will meet the staffing to resident ratio. In addition the administrator agrees to submit a list of staff persons names working in the memory care unit. The administrator shall provide training to all staff by a skilled professional on universal precautions when dealing with a scabies outbreak and shall submit to the licensing agency a signed list by staff persons that received the training.
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Based on interviews and observations the Licensee/Administrator did not ensure that there were enough staff present to ensure that the residents were seen by their physicians to be treated for the rashes, the spreading of scabies and the laundry being completed. This poses a potential health and safety risk to residents in care.
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Plan of correction is to be submitted to CCLD by 10/29/2024.
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:Lauren Crocker
LICENSING EVALUATOR NAME:Rebecca Knight
LICENSING EVALUATOR SIGNATURE:
DATE: 10/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/15/2024


LIC809 (FAS) - (06/04)
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