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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004509
Report Date: 08/19/2024
Date Signed: 08/19/2024 01:32:04 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/18/2024 and conducted by Evaluator Sean Haddad
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240618093048
FACILITY NAME:BONAFIDE HOME CAREFACILITY NUMBER:
306004509
ADMINISTRATOR:ERLEEN B. RINEHARTFACILITY TYPE:
740
ADDRESS:25215 ROMERA PL.TELEPHONE:
(949) 716-4914
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY:6CENSUS: DATE:
08/19/2024
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Erleen B. RineharTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Facility is not providing sufficient hygiene items to residents in care.
Facility is not ensuring the presence of available staff on call overnight.
Resident's room is cluttered.
INVESTIGATION FINDINGS:
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This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of delivering findings for the investigation into the above identified complaint allegations. LPA met with Administrator (AD) Erleen B. Rinehart and explained the reason for today’s inspection.

The investigation into the allegations that the facility is not providing sufficient hygiene items to residents in care, the facility is not ensuring the presence of available staff on call overnight, and a resident's room is cluttered revealed the following: During the course of the investigation, LPA inspected the facility, interviewed AD and residents, and obtained and reviewed copies of the resident roster, staff roster, and resident admission agreements.

CONTINUED
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Armando J LuceroTELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Sean HaddadTELEPHONE: (714) 335-7094
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2024
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 22-AS-20240618093048
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: BONAFIDE HOME CARE
FACILITY NUMBER: 306004509
VISIT DATE: 08/19/2024
NARRATIVE
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Regarding the allegation that the facility is not providing sufficient hygiene items to residents in care: it was alleged that the facility does not have a sufficient quantity of hygiene and toiletry supplies and residents have to provide and store their own supplies because the facility sometimes does not have enough supplies. LPA interviewed AD who denied the allegation, stating the facility supplies shampoo, soap, toothpaste, mouthwash, toilet paper, tissues, paper towels, etc., to residents, the facility maintains a large supply, and the facility has not run out. Regarding shampoo, AD stated that residents bring their own shampoo that meets their specific medical needs, but the facility still has its own supply of shampoo in case residents need it. LPA inspected the facility and observed sufficient supply of all hygiene supplies. LPA interviewed five out of five residents who stated that the facility supplies sufficient hygiene supplies, except two residents who stated they bring their own shampoo. However, LPA observed that the facility has a sufficient supply of its own shampoo. LPA reviewed four resident admission agreements and noted that basic personal care and hygiene supplies are to be provided by the facility but residents are responsible for providing other personal supplies of their choice. The information obtained is conflicting regarding whether shampoo needs to be provided by the facility and whether residents are being offered the facility’s shampoo.

Regarding the allegation that the facility is not ensuring the presence of available staff on call overnight: it was alleged that there are no staff “on the clock” from 7PM to 7AM daily, although residents are provided call lights, and residents are unsure if staff will answer if residents call for help at night. LPA interviewed AD who stated that there are two staff on duty from about 6AM to 10PM daily and that between 10PM and 6AM the two live-in staff are sleeping at the facility and are not on duty, but are available should residents need care. Per AD, the residents rarely need care at night and if they do they have call buttons they can use to request help from staff, the call button sends a loud signal that wakes the staff up, and staff also check on all the residents if the staff get up to use the restroom at night. LPA tested the call system and noted that it triggers a loud bell throughout the house that sounds like a doorbell. AD stated that residents are advised at admission that if they need regular overnight care the facility is able to provide it, but would need to hire additional staff and charge the resident an additional fee to be able to do so. LPA reviewed four resident admission agreements and noted that overnight care is an extra charge and none of these four residents pay the extra charge for overnight care. Per AD, none of the residents at the facility pay the extra charge for overnight care. LPA interviewed five out of five residents and did not obtain information corroborating the allegation. The information obtained did not corroborate the allegation.
SUPERVISOR'S NAME: Armando J LuceroTELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Sean HaddadTELEPHONE: (714) 335-7094
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20240618093048
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: BONAFIDE HOME CARE
FACILITY NUMBER: 306004509
VISIT DATE: 08/19/2024
NARRATIVE
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Regarding the allegation that a resident's room is cluttered: it was alleged that a resident’s room is cluttered and that the resident does not like staff touching their stuff. LPA inspected inside and outside of the facility including six resident rooms, kitchen, and garage and observed the facility to be clean and organized and observed no health and safety issues. LPA observed one resident’s room to contain more possessions than the others, but the room was not cluttered and the resident’s possessions were organized onto shelving and other furniture and the floor was clear and unobstructed. Per AD, this resident likes to buy items via delivery ever day and keeps the items they purchase in their room, but AD has worked with the resident’s family to regularly clean and organize the resident’s possessions. The information obtained did not corroborate the allegation.

Based on the information gathered during the investigation and review of all documents obtained, the Department is unable to ascertain if the above allegations occurred as reported. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred; therefore, these allegations are deemed Unsubstantiated. An exit interview was conducted and a copy of this report was discussed with and provided to facility representative.
SUPERVISOR'S NAME: Armando J LuceroTELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Sean HaddadTELEPHONE: (714) 335-7094
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3