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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880652
Report Date: 10/03/2019
Date Signed: 08/18/2021 10:43:36 AM

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
09/26/2019 and conducted by Evaluator Jennifer Semin
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20190926112814
FACILITY NAME:ABSOLUTE DESERT CARE IFACILITY NUMBER:
331880652
ADMINISTRATOR:CARLOS, CHANNEFACILITY TYPE:
740
ADDRESS:73137 SOMERA RDTELEPHONE:
(951) 742-3448
CITY:PALM DESERTSTATE: CAZIP CODE:
92260
CAPACITY:6CENSUS: 5DATE:
10/03/2019
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Viridiana Cisneros TIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Facility staff physically abused resident.

INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jennifer Semin made an unannounced visit to the facility to deliver the final complaint investigation report. LPA met with Viridiana Cisneros and spoke with Licensee Channe Carlos via telephone. The investigation consisted of interviews with staff, residents and relevant parties. Interviews with residents revealed that although Resident 1 stated staff physically abused them, Residents 2-5 stated they have never been physically abused by any staff nor witnessed any staff physically abusing any resident. Staff 2 and Staff 3 deny physically abusing any residents nor have they witnessed any staff physically abusing any residents. Staff 1 was unable to be interviewed due to three unsuccessful attempts to contact Staff 1. LPA confirmed that Resident 1 did not have a roommate nor were there any witnesses to cooperate the allegation that staff physically abused resident.
Based upon interviews and information gathered, and 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 where this report was discussed with Channe Carlos via telephoneand provided to Viridiana Cisneros
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Jennifer Semin
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
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-20190926112814
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: ABSOLUTE DESERT CARE I
FACILITY NUMBER: 331880652
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/04/2019
Section Cited
CCR
87468.2(a)(8)
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ADDITIONAL PERSONAL RIGHTS OF RESIDENTS IN PRIVATELY OPERATED FACILITIES: In addition to the rights listed in Section 87468. 1. Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following peraonal rights: To be free from neglect,
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Licensee shall read egulations 87466.2 in its entirety and submit a statement of understanding and a staff training log to CCL by the POC due date of 10/4/2019.
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financial exploitation, involuntary seclusion, punishment, humiliation, intimidation & verbal, mental, physical or sexual abuse. This requirement is not met as evidenced by: Interviews conducted corroborated that the bruise on R1 was a result of abuse.
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Type A
10/04/2019
Section Cited
CCR
87468.1(a)(3)
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PERSONAL RIGHTS OF RESIDENTS IN ALL FACILITIES. Residents in all residential care facilities for the elderly shall have all the following personal rights: To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature such as withholding residents' money or interfering with daily living functions such as eating, sleeping,
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Licensee shall read regulation 87468.1 in its entirety and submit a statement of understanding and a staff training log to CCL by the POC due date of 10/4/2019.
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or eliminating. This requirement is not met as evidenced by:Interviews conducted corroborated that the bed was elevated as a restraint so R1 could not get out of bed.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Jennifer Semin
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 2