331880741-7-16-2020-18-AS-KCLS-BZ93N8-20210318182328

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880741
Report Date: 02/05/2020
Date Signed: 07/16/2020 08:33:23 AM

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
01/27/2020 and conducted by Evaluator Jennifer Semin

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20200127121327

FACILITY NAME:	ARLINGTON RIVERSIDE SENIOR COMMUNITY		FACILITY NUMBER:	331880741
ADMINISTRATOR:	HIGGINS, DEBORAH		FACILITY TYPE:	740
ADDRESS:	4609 ARLINGTON AVE		TELEPHONE:	(714) 476-7777
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92504
CAPACITY:	150	CENSUS: 70	DATE:	02/05/2020
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Deborah Higgins		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Facility staff handled resident in a rough manner
Facility staff speak inappropriately to residents
Facility staff are not assisting resident with showering

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jennifer Semin made an unannounced visit to initiate an investigation for the above allegations and deliver the findings. LPA met with Administrator, Deborah Higgins. The investigation consisted of record review and interviews with relevant parties. 5 out of 5 staff interviewed deny handling residents in a rough manner. 3 out of 12 residents interviewed stated staff handle them in a rough manner, howerver, not intentionally, staff just move too quickly. 9 out of 12 residents interviewed stated staff do not handle them in a rough manner.5 out of 5 staff interviewed deny speaking inappropriately to residents. 2 out of 12 residents interviewed stated staff speak inappropriately to the residents and 10 out of 12 residents interviewed stated staff speak appropriately to the residents. 5 out of 5 Staff interviewed stated they assist residents with showering.12 out of 12 Residents interviewed stated staff will assist them with showering if needed.Based on documents and interviews conducted and although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED at this time.An exit interview was conducted where this report was discussed and provided to Ms. Higgins.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 836-2784
LICENSING EVALUATOR NAME: Jennifer Semin	TELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2020

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

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
01/27/2020 and conducted by Evaluator Jennifer Semin

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20200127121327

FACILITY NAME:	ARLINGTON RIVERSIDE SENIOR COMMUNITY		FACILITY NUMBER:	331880741
ADMINISTRATOR:	HIGGINS, DEBORAH		FACILITY TYPE:	740
ADDRESS:	4609 ARLINGTON AVE		TELEPHONE:	(714) 476-7777
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92504
CAPACITY:	150	CENSUS: 70	DATE:	02/05/2020
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Jenesa McDonald		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Facility staff are not keeping the facility clean

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jennifer Semin contacted the facility via telephone due to COVID-19, to deliver the finding for the above allegation. LPA met with Busiess Office Manager, Jenesa McDonald.
The investigation consisted of observations and interviews with staff and residents. Interviews with 5 staff revealed the facility is kept clean. Interviews with 12 residents revealed the facility is kept the facility clean. LPA toured the facility inside and out, and found the facility to be clean, including hallways, walkways, kitchen, dining room, common activity rooms, bathrooms and resident bedroom rooms.
Based on observations and interviews conducted and 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, therefore the allegation is UNSUBSTANTIATED at this time.
An exit interview was conducted where this report was discussed and provided to Ms. McDonald via email.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 836-2784
LICENSING EVALUATOR NAME: Jennifer Semin	TELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2021

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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