331800065-9-24-2020-18-AS-KCLS-BU8MCR-20201009093000

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331800065
Report Date: 09/23/2020
Date Signed: 09/24/2020 04:23:19 PM

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
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/16/2020 and conducted by Evaluator Kiana Clark

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20200916085125

FACILITY NAME:	SACRED HEART-EDGEMONT		FACILITY NUMBER:	331800065
ADMINISTRATOR:	MACIAS, EVELYN		FACILITY TYPE:	740
ADDRESS:	37212 EDGEMONT DRIVE		TELEPHONE:	(949) 257-8344
CITY:	MURRIETA	STATE: CA	ZIP CODE:	92563
CAPACITY:	6	CENSUS: 4	DATE:	09/23/2020
		UNANNOUNCED	TIME BEGAN:	03:40 PM
MET WITH:	Arturo Rodriguez		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Facility is in disrepair

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kiana Clark contacted the facility via telephone to commence a complaint investigation via telephone due to COVID-19. LPA identified herself and discussed the purpose of the call and the elements of the allegation(s) with caregiver, Arturo Rodriguez. The Administrator Evelyn Macias and Licensee Bruce Smerker were not at the facility at the time of my phone call.

The investigation consisted of interviews with relevant parties such as the licensee, two caregivers, and two residents. The allegation indicates that the facility is in disrepair. Interviews with caregivers revealed they were not aware of any facility ramps being in disrepair and have not observed any damaged ramps. The licensee stated that no one has mentioned any problems about the ramps, and denied the ramps are in disrepair. Facility staff provided LPA Kiana Clark pictures of the facility ramps to show that the

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Kiana Clark	TELEPHONE: (951) 218-3893
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2020

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 18-AS-20200916085125

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
RIVERSIDE, CA 92507

FACILITY NAME: SACRED HEART-EDGEMONT	FACILITY NUMBER: 331800065
	VISIT DATE: 09/23/2020

NARRATIVE

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ramps are secure and safe. Interviews with Resident 1 (R1) who confirmed using a wheelchair to enter and exit the facility stated there are no issues with the ramps. Resident 2 (R2) who also uses a wheelchair stated they have not observed any issues with the ramps. The two residents interviewed reported they do not have any trouble going in and out of the facility and have not heard of any complaints about the ramps, further stating that the ramps seem secure.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation(s) are unsubstantiated at this time.

No deficiencies were cited during this visit. An exit interview was conducted where this report was discussed and provided to the licensee.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Kiana Clark	TELEPHONE: (951) 218-3893
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2020

LIC9099 (FAS) - (06/04)

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