331800063-3-21-2023-56-AS-EMAN-CRUKVN-20230515081436

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331800063
Report Date: 03/21/2023
Date Signed: 03/21/2023 09:33:55 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/08/2023 and conducted by Evaluator Melody Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20230308095318

FACILITY NAME:	GARDENS OF RIVERSIDE, THE		FACILITY NUMBER:	331800063
ADMINISTRATOR:	STEPHANIE ODEN		FACILITY TYPE:	740
ADDRESS:	10849 ARLINGTON AVE		TELEPHONE:	(951) 637-8844
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92505
CAPACITY:	98	CENSUS: 90	DATE:	03/21/2023
		ANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Executive Director Stephanie Oden and Resident Care Director Jessica Padron		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Staff do not provide adequate supervision to residents in care.
Resident's screen door is in disrepair.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Melody Brown and Mary Rico met with Executive Director Stephanie Oden and Resident Care Director Jessica Padron at Community Care Licensing Division (CCLD) Adult and Senior Care (ASC) Regional Office 03/21/2023 at 09:05 AM to deliver the findings of the above allegation. LPAs Brown and Rico explained the purpose of the requested Office Visit. The investigation consisted of observation, interviews and a review of pertinent documentations.

The investigation was conducted by LPA Brown. The investigation consisted of file review and interviews with relevant parties. The first allegation indicates Staff do not provide adequate supervision to residents in care. During the investigation, LPA Brown did not find evidence to corroborate the allegation. Interviews with staffs and residents indicated that staffs at the facility provides adequate supervision to residents in care. Residents’ interviews revealed that staffs are checking on them constantly, checking on them every hour to two (hours) to make sure that they are well and staff always asked and offer their assistance to the residents. *** Continuation on LIC9099C ***

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Melody Brown	TELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

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

LIC9099 (FAS) - (06/04)

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Control Number 56-AS-20230308095318

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

FACILITY NAME: GARDENS OF RIVERSIDE, THE	FACILITY NUMBER: 331800063
	VISIT DATE: 03/21/2023

NARRATIVE

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Staffs’ interviews indicated that they are monitoring and checking all residents every hour to two (2) hours to make sure that all residents in care are doing well. In addition, LPA Brown reviewed the facility’s Personnel Summary Report (LIC500) and it showed that the facility had sufficient number of staff monitoring and supervising all residents at the facility.

During the facility visit last 03/15/2023, LPA Brown observed that five (5) staffs work at Magnolia Building and three (3) staffs were assigned to Jasmin Building. Moreover, during the facility visit last 03/15/2023, Executive Director Oden reported to LPA Brown that all staffs at the facility are checking and supervising all residents at the facility every hour to every two (2) hours, sometimes more frequent to make sure that all residents are provided appropriate care and supervision. In addition, during the facility visit last 03/15/2023, Resident Care Director Jessica Padron reported “All staffs here checked, supervised, and monitor residents every two (2) hours, and other residents that needs more supervision were checked more frequently."

The second allegation indicates that Resident’s screen door is in disrepair. During the investigation, LPA Brown did not find evidence to corroborate the allegation. Interviews with residents indicated that their door was not in disrepair and on situation that they broke their screen door, the facility staff will immediately repair it. Residents’ interviews also revealed that no incident happened at the facility where a broken screen door where not immediately repaired or replaced if needed. Staff interviews indicated that if they noticed a residents’ screen door broken, or if it was reported to them that the resident screen door was broken, they immediately notify ED Oden so the facility staff can immediately repair it and address the issue. Staff interviews also revealed that they are not aware of an incident at the facility where a residents’ screen door is in disrepair or a residents’ broken screen door were not immediately repaired. During the facility visit last 03/15/2023, LPA Brown observed Resident #1 (R1) screen door in good condition, not in disrepair.

Based on interviews and records review, the allegation Staff do not provide adequate supervision to residents in care (Allegation #1) and Resident’s screen door is in disrepair (Allegation #2) are UNSUBSTANTIATED. A finding of unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted, where this report (LIC9099) was discussed and provided to Executive Director Stephanie Oden and Resident Care Director Jessica Padron.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Melody Brown	TELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

LIC9099 (FAS) - (06/04)

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