331880734-3-20-2024-18-AS-TDAN-D3RURH-20240327154847

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880734
Report Date: 03/20/2024
Date Signed: 03/20/2024 12:54:33 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE 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
03/13/2024 and conducted by Evaluator Sara Martinez

COMPLAINT CONTROL NUMBER: 18-AS-20240313165847

FACILITY NAME:	RANCHO MIRAGE TERRACE		FACILITY NUMBER:	331880734
ADMINISTRATOR:	MONIQUE MOREIRA		FACILITY TYPE:	740
ADDRESS:	34560 BOB HOPE DRIVE		TELEPHONE:	(760) 770-7737
CITY:	RANCHO MIRAGE	STATE: CA	ZIP CODE:	92270
CAPACITY:	142	CENSUS: 124	DATE:	03/20/2024
		UNANNOUNCED	TIME BEGAN:	09:26 AM
MET WITH:	Executive Director Monique Moreira		TIME COMPLETED:	01:04 PM

ALLEGATION(S):

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Staff will not change resident's diaper

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sara Martinez conducted an unannounced visit to initiate and deliver findings regarding the allegation listed above. LPA was granted entry and met with Executive Director Monique Moreira, who was Informed of the purpose of the visit. LPA toured the facility, conducted interviews, and collected pertinent documents regarding the allegation listed above.

Regarding the allegation “Staff will not change resident's diaper” it was reported the facility is refusing to change Resident One (R1) diaper. Interview with R1 revealed staff will ask R1 if their diaper needs to be changed or staff will turn R1 to inspect R1’s diaper throughout the day. R1 denied the allegation of staff not changing their diaper. Interview with Resident Service Coordinator Jillian Ryan revealed staff check on R1 every two hours or if R1 has a bowel movement, R1 will call the front desk and staff will assist R1 with changing their diaper. Record review of R1’s needs and service plan dated 02/07/2024 revealed R1 did not require assistance from staff with toileting but due to R1’s change in condition, R1 is incontinent and requires care and staff assistance.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Sara Martinez	TELEPHONE: (951) 605-0913
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024

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-20240313165847

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: RANCHO MIRAGE TERRACE	FACILITY NUMBER: 331880734
	VISIT DATE: 03/20/2024

NARRATIVE

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Therefore based on interviews and record review, the allegation “Staff will not change resident’s diaper” has been deemed UNSUBTATIANED at this time.
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 and a copy of this report was provided to Executive Director Monique Moreira.

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Sara Martinez	TELEPHONE: (951) 605-0913
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024

LIC9099 (FAS) - (06/04)

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