306005408-7-28-2023-22-AS-SSAS-CUD26C-20230803170657

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005408
Report Date: 07/28/2023
Date Signed: 07/28/2023 11:54:31 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
05/13/2021 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20210513122235

FACILITY NAME:	CORNERSTONE HOMES		FACILITY NUMBER:	306005408
ADMINISTRATOR:	SATHER, JOSEPH		FACILITY TYPE:	740
ADDRESS:	27076 LOST COLT DRIVE		TELEPHONE:	(949) 360-4314
CITY:	LAGUNA HILLS	STATE: CA	ZIP CODE:	92653
CAPACITY:	6	CENSUS: 6	DATE:	07/28/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Joseph Sather		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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-Staff sleeping in common areas

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez visited the facility to deliver findings for the investigation into the above identified complaint allegations. LPA arrived at facility and was greeted at the door by staff and granted entry. LPA spoke with Joseph Sather, Administrator and explained the purpose of the visit.

Findings are based upon this investigation which included records review, and interviews conducted.
It is alleged that staff are sleeping in common areas. Interviews conducted with 2 of 2 staff revealed that staff has never witnessed another staff member sleeping in common spaces. Staff indicated that when they need to sleep or take a nap, they do so in the caregiver designated bedroom. Interview with 3 of 6 resident revealed that they have never seen a caregiver sleeping in any common space. Residents indicated that they think the caregivers are too busy helping the residents, cleaning, and cooking to be able to take naps

Continued on LIC809-D

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (949) 430-1222
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023

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 4

Control Number 22-AS-20210513122235

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: CORNERSTONE HOMES	FACILITY NUMBER: 306005408
	VISIT DATE: 07/28/2023

NARRATIVE

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during their working hours. Interview conducted with 1 of 1 witness indicated that they have never seen any caregiver sleep during the day in any of the common spaces around the facility.

Based on the information mentioned above, the Department is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed Unsubstantiated.

An exit interview was conducted with Administrator and a copy of this LIC9099 report was left at facility.

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (949) 430-1222
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
05/13/2021 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20210513122235

FACILITY NAME:	CORNERSTONE HOMES		FACILITY NUMBER:	306005408
ADMINISTRATOR:	SATHER, JOSEPH		FACILITY TYPE:	740
ADDRESS:	27076 LOST COLT DRIVE		TELEPHONE:	(949) 360-4314
CITY:	LAGUNA HILLS	STATE: CA	ZIP CODE:	92653
CAPACITY:	6	CENSUS: 6	DATE:	07/28/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Joseph Sather		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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-Facility is not following reporting requirements

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez visited the facility to deliver findings for the investigation into the above identified complaint allegations. LPA arrived at facility and was greeted at the door by staff and granted entry. LPA spoke with Joseph Sather, Administrator and explained the purpose of the visit.

Findings are based upon this investigation which included records review, and interviews conducted.
It is alleged facility is not following reporting requirements. Interviews conducted with staff (S1) indicated that they weren’t aware that the case open with Department of Labor should had been reported to our department. Based on record review it does not indicate that information from Administrator was reported on the case open with Department of Labor. In review of Administrator requirement per regulations reporting requirements indicates that a licensee is required to notify the department in the event of; death

Continued on LIC809-C

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (949) 430-1222
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 22-AS-20210513122235

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: CORNERSTONE HOMES	FACILITY NUMBER: 306005408
	VISIT DATE: 07/28/2023

NARRATIVE

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of any resident, any serious injury, the use of an automated external defibrillator, any incident that threatens the welfare, safety or health of any resident, unexplained absence of any resident, occurrences, such as epidemic outbreaks, poisonings, catastrophes or major accidents which threaten the welfare, safety or health of residents, personnel or visitors, fires of explosions which occur in or the premises, and any suspected physical abuse that results in serious bodily injury of a resident. Therefore, the case open with Department of Labor was not required to be reported to the Department.

Based on observations and review of documents, we have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted with Administrator and a copy of this LIC9099 report was left at facility.

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (949) 430-1222
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 4