331880541-5-10-2022-18-AS-JESL-CHNTK4-20220826144719

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880541
Report Date: 05/10/2022
Date Signed: 05/10/2022 12:15:20 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
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/03/2022 and conducted by Evaluator Crystal Colvin

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20220503084418

FACILITY NAME:	ROLLING GREEN SENIOR CARE		FACILITY NUMBER:	331880541
ADMINISTRATOR:	OKORO, GERTRUDE		FACILITY TYPE:	740
ADDRESS:	42007 THOROUGHBRED LN		TELEPHONE:	(951) 397-3369
CITY:	MURRIETA	STATE: CA	ZIP CODE:	92562
CAPACITY:	6	CENSUS: 4	DATE:	05/10/2022
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Gertrude "Trudy" Okoro - Licensee/Administrator		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff member made inappropriate comments to resident and emotionally abused resident.

Resident was left in bed for an excessive amount of time.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility unannounced in order to initiate an investigation of a complaint with the above allegation(s). LPA identified herself and discussed the purpose of the visit and the elements of the allegation(s) with Licensee/Administrator Gertrude "Trudy" Okoro. Below is a summary of the findings of this complaint:

Regarding allegation "Staff member made inappropriate comments to resident and emotionally abused resident": LPA Colvin interviewed residents, staff, and other persons regarding the allegation. Interviews were inclonclusive regarding staff member's (S1) alleged inappropriate statements and emotional abuse towards resident(s). In an abundance of caution, Licensee/Administrator "Trudy" removed S1 from the scheudle on a temporary basis until a new resident that was clashing with S1 could adjust to living in a facility for the first time. According to all interviews, there is no longer any issue with S1, and all parties are comfortable with S1 returning to the facility. Unfortunately, LPA Colvin was unable to interview all residents (some sleeping) and S1, however, it is unlikely that these interviews would change the finings of this investigation.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Crystal Colvin	TELEPHONE: (951) 204-0848
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2022

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-20220503084418

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: ROLLING GREEN SENIOR CARE	FACILITY NUMBER: 331880541
	VISIT DATE: 05/10/2022

NARRATIVE

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Based on interviews conducted and lack of any further evidence to support the claim, the allegation "Staff member made inappropriate comments to resident and emotionally abused resident" is UNSUBSTANTIATED.

Regarding allegation "Resident was left in bed for an excessive amount of time": LPA Colvin interviewed residents and outside agencies who would have information relevant to the allegation. Additionally, LPA Colvin interviewed the reporting party, who clarified that the allegation included time that the residents were asleep overnight. LPA Colvin did not observe in interviews or record review any evidence that would suggest that resident(s) have been left in bed for an extended period of time, such as bedsores or pressure injuries. Therefore, due to lack of evidence, the allegation is UNSUBSTANTIATED.

A finding of 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.

An exit interview was conducted with Licensee/Administrator Gertrude "Trudy" Okoro and a copy of this report was provided.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Crystal Colvin	TELEPHONE: (951) 204-0848
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2022

LIC9099 (FAS) - (06/04)

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