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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331800103
Report Date: 08/18/2020
Date Signed: 08/18/2020 01:32:45 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:LEGEND GARDENSFACILITY NUMBER:
331800103
ADMINISTRATOR:YNDIRA LEPEFACILITY TYPE:
740
ADDRESS:73685 CATALINA WAYTELEPHONE:
(760) 773-3115
CITY:PALM DESERTSTATE: CAZIP CODE:
92260
CAPACITY:96CENSUS: 44DATE:
08/18/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:AnnaMaria Valenzuela, Wellness DirectorTIME COMPLETED:
01:35 PM
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Licensing Program Analyst (LPA) Tricia Danielson contacted the facility via telephone as a continued follow up to a self reported incident by the facility. This visit is being conducted via telephone and Facetime video conference due to COVID-19 and for precautionary measures. LPA met with Wellness Director (WD) Annamaria Valenzuela.

On 8/11/2020, WD contacted LPA to report an incident pertaining to abuse of three (3) residents of the facility by a staff member. WD reported three (3) staff members had reported they each had observed several incidents of verbal and physical abuse of residents by Staff #1 (S1). During today's virtual visit, LPA interviewed the three (3) affected residents listed in the incident report. The three (3) staff witnesses were previously interviewed by LPA as well. WD reported S1 had been immediately suspended following the reported abuse and has since been terminated. WD reported the Palm Desert Sheriff was notified and a report was made. WD reported the affected residents were given physical exams and no injuries were noted.

An exit interview was conducted with WD via telephone and a copy of this report was provided to WD via email and an electronic email read receipt confirms receipt of these documents. WD has also agreed to sign the report and return a copy to LPA via email and/or fax.
SUPERVISOR'S NAME: Reyna LaceyTELEPHONE: (951) 836-3135
LICENSING EVALUATOR NAME: Tricia DanielsonTELEPHONE: (951) 565-7254
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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