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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800063
Report Date: 05/08/2024
Date Signed: 05/08/2024 02:42:32 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
09/13/2023 and conducted by Evaluator Melody Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20230913100959
FACILITY NAME:GARDENS OF RIVERSIDE, THEFACILITY NUMBER:
331800063
ADMINISTRATOR:STEPHANIE ODENFACILITY TYPE:
740
ADDRESS:10849 ARLINGTON AVETELEPHONE:
(951) 637-8844
CITY:RIVERSIDESTATE: CAZIP CODE:
92505
CAPACITY:98CENSUS: 86DATE:
05/08/2024
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Executive Director Griselda Torres Garcia TIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Staff is not properly administering medication.
Staff is not properly trained on medication assistance.
Staff is administering PRN medication without responsible party consent.
Staff is not meeting residents needs.
Staff is violating residents personal rights.
Staff is not properly trained on how to use mechanical lifts.
INVESTIGATION FINDINGS:
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On 05/08/2024 at 01:45 PM, Licensing Program Analysts (LPAs) Melody Brown and Sarina Ramirez met with Executive Director Griselda Torres Garcia 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 documentation.

The investigation was conducted by LPA Melody Brown. The investigation consisted of file review and
interviews with relevant parties. The first allegation indicates that Staff is not properly administering medication. During the investigation, LPA Brown did not find evidence to corroborate the allegation. Interviews with five (5) of five (5) residents indicated that staffs at the facility are properly administering their medication as they always get their medication on time daily. LPA Brown unable to interview Resident #1 (R1) as R1 moved out at the facility on 09/30/2023. Interviews with six (6) of seven (7) staffs ***Continuation in LIC9099C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Melody BrownTELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024
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 56-AS-20230913100959
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: 05/08/2024
NARRATIVE
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indicated that they are properly administering residents medication per their doctors order and all staffs
interviewed reported that no incident happened at the facility that a staff did not properly administer medication to a resident. During the facility visit on 11/08/2023, LPA Brown observed MedTech staffs appropriately dispensing residents’ medication per doctor's order as evidenced of MedTech staffs utilizing Medication Administration Record (MAR) as they dispensed residents medication. LPA Brown reviewed R1's MAR and observed that R1's medications were dispensed per doctor's order.

The second (2nd) allegation indicates Staff is not properly trained on medication assistance. Interviews with six (6) of seven (7) staffs indicated that Medical Technician (MedTech) staffs at the facility are all properly trained on medication assistance. Interviews with six (6) of seven (7) staffs revealed that medication training is a requirement to all MedTech staffs before they can give medications to their residents. LPA Brown reviewed facility staff files and LPA Brown observed that Medical Technician (MedTech) staffs at the facility were provided medication training and MedTech staffs completed the required medication training.

The third (3rd) allegation indicates Staff is administering PRN medication without responsible party consent. Interviews with four (4) of five (5) staffs indicated that PRN (As Needed) medications of residents at the facility have physician orders and that's what MedTech staffs follow and no consent from a resident's responsible party is needed or required before a MedTech staff can give the resident's PRN medications. LPA Brown reviewed R1 MAR and LPA Brown observed that there's no written order from R1's Physician indicating the need for R1's Responsible Party consent before administering R1's PRN medication. In addition, per documents review and interview with Staff #2 (S2), LPA Brown noted that the facility obtained a new written order from R1's Physician indicating the need for R1's Responsible Party consent before administering R1's PRN medication to address the issue reported and on 09/12/2023, LPA Brown observed that R1's Physician discontinued R1's PRN medication per R1's MAR review.

The fourth allegation indicates Staff is not meeting residents needs. During the investigation, LPA Brown did not find evidence to corroborate the allegation. Interviews with five (5) of five (5) residents indicated that all staffs at the facility are meeting their needs as staffs always check on them, provide assistance if they need help and staffs make sure that they were all provided the care and supervision that they need. LPA Brown

***Continuation in LIC9099C*** ***This is an amended copy***

SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Melody BrownTELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 56-AS-20230913100959
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: 05/08/2024
NARRATIVE
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unable to interview Resident #1 (R1) as R1 moved out at the facility on 09/30/2023. Interviews with six (6) of seven (7) staffs indicated that they are all meeting their residents needs as they all make sure that appropriate care and supervision were provided to all their residents. Interviews with six (6) of seven (7) staffs revealed that there's no incident that happened at the facility that a staff did not meet resident' needs.

The fifth (5th) allegation indicates Staff is violating residents’ personal rights. Interviews with five (5) of five (5) residents indicated that staffs at the facility are not violating their personal rights. Five (5) of five (5) residents interviewed reported that staffs at the facility are all kind and all are good to them, always ready to assist them if needed. Five (5) of five (5) residents interviewed revealed that no incident happened at the facility that a staff violated a residents' personal rights. LPA Brown unable to interview Resident #1 (R1) as R1 moved out at the facility on 09/30/2023. Interviews with four (4) of five (5) staffs indicated that no staff at the facility are violating their residents’ personal rights. Staff interviewed reported that they are treating their residents as their family, they are all respectful to their residents and all staffs interviewed denied violating residents personal rights, witnessing a staff violating residents personal rights or knowledge of an incident that a staff violated their residents personal rights.



The sixth (6th) allegation indicates Staff is not properly trained on how to use mechanical lifts. Interviews with four (4) of five (5) staffs indicated that they were all provided training on how to use mechanical lifts either by the facility's Resident Care Director or a Hospice Nurse. During the facility visit on 11/08/2023, Executive Director Griselda Torres Garcia provided LPA Brown the Staffs Training Log on Mechanical Lift.

Based on the evidence, the allegation that Staff is not properly administering medication (Allegation #1), Staff is not properly trained on medication assistance (Allegation #2), Staff is administering PRN medication without responsible party consent (Allegation #3), Staff is not meeting residents needs (Allegation #4), Staff is violating residents personal rights (Allegation #5), Staff is not properly trained on how to use mechanical lifts (Allegation #6) are UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated at this time.

An exit interview was conducted where this report, LIC9099 was discussed and provided to Executive Director Griselda Torres Garcia. ***This is an amended copy***

SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Melody BrownTELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3