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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800469
Report Date: 03/26/2025
Date Signed: 03/26/2025 01:17:55 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 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
03/24/2025 and conducted by Evaluator Becky Mann
COMPLAINT CONTROL NUMBER: 56-AS-20250324103514
FACILITY NAME:RAPHA HOUSEFACILITY NUMBER:
331800469
ADMINISTRATOR:KNIGHTEN, CASSANDRAFACILITY TYPE:
735
ADDRESS:13310 OCOTILLO ROADTELEPHONE:
(951) 378-3800
CITY:WHITEWATERSTATE: CAZIP CODE:
92282
CAPACITY:4CENSUS: 3DATE:
03/26/2025
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Umeka Foster, Facility ManagerTIME COMPLETED:
01:25 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not ensure resident was taken to the hospital
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Becky Mann conducted an unannounced visit to the facility to initiate a complaint investigation. LPA met with Umeka Foster, Facility Manager and explained the purpose of the visit. The investigation consisted of LPA pertinent record reviews, observations, interviews with staff and clients.

The allegation that staff did not ensure resident was taken to the hospital. Two (2) staff interviewed stated that they do ensure that the resident is taken to the hospital. Two (2) clients interviewed stated that staff does take the client to the hospital.

Based on evidence obtained during this investigation, the allegation above is Unsubstantiated; meaning that 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.
An exit interview was conducted where this report was discussed and a copy of this report was provided to Umeka Foster, Facility Manager at the conclusion of the visit.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Becky Mann
LICENSING EVALUATOR SIGNATURE:

DATE: 03/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2025
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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