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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800065
Report Date: 09/02/2021
Date Signed: 09/09/2021 02:53:05 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
11/04/2020 and conducted by Evaluator Deborah Mullen
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20201104090744
FACILITY NAME:SACRED HEART-EDGEMONTFACILITY NUMBER:
331800065
ADMINISTRATOR:MACIAS, EVELYNFACILITY TYPE:
740
ADDRESS:37212 EDGEMONT DRIVETELEPHONE:
(949) 257-8344
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY:0CENSUS: 0DATE:
09/02/2021
UNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Bruce Smerker, LicenseeTIME COMPLETED:
11:55 AM
ALLEGATION(S):
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Facility staff refused visitor entrance into the facility to visit resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Deborah Mullen delivered the findings of the above allegation. LPA met with Bruce Smerker, Licensee. The Department investigation included interviews with the Licensee, staff and other pertinent witness. Due to the closure of the facility LPA was unable to interview additional witnesses.

According to information received, a caregiver who no longer worked at the facility was not allowed inside the facility to visit a resident. Licensee stated in October 2020 only immediate family was being allowed inside the facility to visit residents due to Covid. He said at that time no one was vaccinated, and we were still following the Departments guidelines regarding restricting visitors at the facility. He said they were following Department guidelines when they denied the prior caregiver entrance inside the facility to visit a resident.

Based on information obtained there is not enough evidence to state facility staff violated regulations by refusing the visitor entrance into the facility. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report was reviewed with and provided to Bruce Smerker, Licensee.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Karen ClemonsTELEPHONE: (951) 836-2784
LICENSING EVALUATOR NAME: Deborah MullenTELEPHONE: (951) 212-0616
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021
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 2
Control Number 18-AS-20201104090744
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: 09/02/2021
NARRATIVE
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This page created in error.
SUPERVISOR'S NAME: Karen ClemonsTELEPHONE: (951) 836-2784
LICENSING EVALUATOR NAME: Deborah MullenTELEPHONE: (951) 212-0616
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2