331800063-9-22-2023-56-AS-EMAN-CW5MQP-20230929094900

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331800063
Report Date: 09/22/2023
Date Signed: 09/22/2023 02:03:34 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, 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
02/24/2023 and conducted by Evaluator Melody Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20230224064326

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:	09/22/2023
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Executive Director Griselda Torres Garcia and Resident Care Director Jessica Padron		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Resident sustained bruised while in care due to neglect or lack of supervision.
Resident physically abused while in care.
Facility failed to seek medical attention for the resident in a timely manner.
Facility failed to report incident.

INVESTIGATION FINDINGS:

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On 09/22/2023 at 01:30 PM, Licensing Program Analyst (LPA) Melody Brown met with Executive Director Griselda Torres Garcia and Resident Care Director Jessica Padron at Community Care Licensing Division (CCLD) Adult and Senior Care (ASC) Regional Office to deliver the findings of the above allegations. LPA Brown explained the purpose of the requested Office Visit. The investigation consisted of observation, interviews and a review of pertinent documentations.

Regarding allegation "Resident sustained bruised while in care due to neglect or lack of supervision," LPA Brown interviewed Staff #1 (S1), Staff #2 (S2), Staff #3 (S3), Staff #7 (S7) and Staff #8 (S8) who denied observing a resident that sustained bruised while in care. S1, S2, S3, S7 and S8 interviews indicated that they are all monitoring all residents in care and they are checking on them every one (1) hour or two (2) hours or more frequently if needed.

*** Continuation in 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: 09/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023

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 3

Control Number 56-AS-20230224064326

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: 09/22/2023

NARRATIVE

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LPA Brown interviewed Resident #4 (R4), Resident #5 (R5), Resident #7 (R7) and Resident #8 (R8) and they all indicated that all staff at the facility are providing supervision and assisting them with all their needs. Moreover, R4, R5, R7 and R8 interviews revealed that they did not see any resident at the facility that sustained bruised due to staff neglect or lack of supervision.

Regarding allegation "Resident physically abused while in care," the Department investigation consisted of file reviews, interviews with residents, staff, witnesses and collecting pertinent records. Based upon the investigation, the Department could not determine that Resident 1 (R1) was physically abused while in care. R1 was observed to have bruises on both wrists and forearms. Staff interviewed denied causing the bruises to R1 or knowing how R1 sustained the bruises. Records reviewed revealed no documented incidents of falls or altercations with staffs or residents. R1's medical records indicated no fracture sustained. R1 was unable to say how R1 sustained the injuries during the interview. The Department could not find evidence to corroborate the allegation.

Regarding allegation "Facility failed to seek medical attention for the resident in a timely manner," LPA Brown interviewed Resident #4 (R4), Resident #5 (R5), Resident #7 (R7) and Resident #8 (R8) and R4, R5, R7 and R8 reported that all facility staffs seek medical attention for them if needed and no incident happened at the facility that a staff did not seek timely medical attention for a resident. Staff #1 (S1), Staff #2 (S2), Staff #3 (S3), Staff #7 (S7) and Staff #8 (S8) interviews revealed they all provided immediate assistance on seeking medical attention to all residents in care. S2 reported to LPA Brown that R1 was assessed immediately upon receiving the information on R1's bruised on 02/22/2023 and R1 did not report any pain and had full range of motion. S2 added that R1 had a Telehealth visit the same day 02/22/2023 with a Nurse Practitioner and Xrays were ordered.

Regarding allegation "Facility failed to report incident," LPA Brown interviewed Resident #4 (R4), Resident #5 (R5), Resident #7 (R7) and Resident #8 (R8) and Staff #1 (S1), Staff #2 (S2), Staff #3 (S3), Staff #7 (S7) and Staff #8 (S8) interviews indicated that staffs are reporting all incidents at the facility to their family or responsible party.
*** Continuation in LIC9099C ***

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Melody Brown	TELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023

LIC9099 (FAS) - (06/04)

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Control Number 56-AS-20230224064326

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: 09/22/2023

NARRATIVE

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S1, S2, S3, S7 and S8 interviews revealed that they always report all incident at the facility, and they all denied any incident that they failed to report an incident to a residents' family, responsible party or state agency. Records reviewed indicated that the facility reported the incident to R1's family, responsible party and Department of Social Services (DSS) Community Care Licensing Division (CCLD).

As a result of investigation, the allegations Resident sustained bruised while in care due to neglect or lack of supervision (Allegation #1), Resident physically abused while in care (Allegation #2), Facility failed to seek
medical attention for the resident in a timely manner (Allegation #3), Facility failed to report incident (Allegation #4) are determined to be UNSUBSTANTIATED, meaning that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted where this report, LIC9099 was discussed, and a copy was provided to Executive Director Griselda Torres Garcia 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: 09/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023

LIC9099 (FAS) - (06/04)

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