331880741-6-5-2024-18-AS-TDAN-D5XSWV-20240605141457

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880741
Report Date: 05/20/2024
Date Signed: 06/05/2024 11:27:45 AM

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
03/19/2024 and conducted by Evaluator Janette Romero

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20240319160320

FACILITY NAME:	ARLINGTON RIVERSIDE SENIOR COMMUNITY		FACILITY NUMBER:	331880741
ADMINISTRATOR:	WILLIAMS, MORGAN E		FACILITY TYPE:	740
ADDRESS:	4609 ARLINGTON AVE		TELEPHONE:	(951) 462-1025
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92504
CAPACITY:	0	CENSUS: 88	DATE:	05/20/2024
		UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Administrator, Morgan Williams		TIME COMPLETED:	03:05 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility is not in sanitary condition.
Residents are consistently being intimidated by staff.
Residents experiencing high anxiety with pressure from staff.
Residents receiving SSI are being charged 2x-3x times more than the standard allowed rate.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 5/20/2024, Licensing Program Analyst (LPA), Janette Romero arrived unannounced to deliver amended findings regarding the above allegations. LPA met Administrator, Morgan Williams was informed of the purpose of LPA's visit.

Regarding the allegation, “Facility is not in sanitary condition” it was alleged the entire facility carpet is dirty and there is a lingering odor throughout the facility. Regional Manager (RM), Reyna Lacey and LPA Romero toured the facility and observed some carpet stains but did not detect a foul odor. Five (5) of nine (9) residents interviewed reported facility staff clean the carpets on a regular basis. Three (3) of nine (9) residents interviewed reported they are not aware of any stains on the carpets, or they have not detected an odor from the carpets.

*This an amended version of the original report

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janette Romero	TELEPHONE: (951) 529-2930
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2024

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 4

Control Number 18-AS-20240319160320

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: ARLINGTON RIVERSIDE SENIOR COMMUNITY	FACILITY NUMBER: 331880741
	VISIT DATE: 05/20/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

LPA interviewed two (2) housekeepers who reported the hallway carpets are shampooed twice a week and there is not a lingering odor. Resident interviews added the facility is in the process of removing all the carpets and installing new vinyl flooring throughout the facility. This was confirmed by Administrator Williams who added the facility is working by sections to install the new flooring. Only one (1) of ten (10) residents interviewed corroborated the allegation.

It was also alleged the facility uses roach traps in place of an exterminator. Seven (7) of ten (10) residents interviewed reported they have not observed roaches or bugs at the facility. One (1) resident interviewed reported they have observed one (1) roach since September of 2023, but it is not a problem. Another resident reported they have an ongoing issue with bedbugs and the facility’s pest control company, Orkin, has visited the facility every other day to treat the affected areas. A different resident reported the roach traps were placed by Orkin. Out of 10 residents interviewed, no one reported the facility uses roach traps in place of an exterminator.

Two (2) housekeepers were interviewed and reported the facility has a pest control company in place providing ongoing monthly treatments and additional treatments as necessary. Administrator Williams provided a copy of the facility’s contract with Orkin, which notes 14 bait stations were installed at the facility. LPA contacted Orkin and was informed the 14 bait stations were installed on 7/27/2023 as part regular ongoing treatment and based on the size of the facility. Orkin reported they provide ongoing treatment twice per month and additionally as need.

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janette Romero	TELEPHONE: (951) 529-2930
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 18-AS-20240319160320

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: ARLINGTON RIVERSIDE SENIOR COMMUNITY	FACILITY NUMBER: 331880741
	VISIT DATE: 05/20/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Regarding the allegation, “Residents are consistently being intimidated by staff” it was alleged facility staff are having residents sign documents they do not comprehend. It was also alleged R1 was pressured to sign documentation without representation. Seven (7) of eight (8) residents interviewed reported they have never been intimidated by staff to sign documents they do not understand. LPA reviewed R1’s physician report which notes R1 is able to follow instructions, not confused or disoriented, and is not diagnosed with mild cognitive impairment or dementia. LPA reviewed R1’s admission agreement, which does not list a responsible person other than themselves. LPA also reviewed R1’s Identification and Emergency Information (LIC601) which indicates R1 as the person responsible for “financial affairs, payment for care and legal guardian”. Administrator Williams reported the facility does not have documentation for a power of attorney agent or conservator in place for R1 and R1 has the mental capacity to review and sign or refuse to sign documents. Administrator Williams added the facility has never intimidated residents to sign documents they do not comprehend, and all residents have the mental capacity to review documents or have their lawyers review documents before submitting them to the facility.

*This is an amended version of the original report

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janette Romero	TELEPHONE: (951) 529-2930
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 18-AS-20240319160320

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: ARLINGTON RIVERSIDE SENIOR COMMUNITY	FACILITY NUMBER: 331880741
	VISIT DATE: 05/20/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Regarding the allegation, “Residents experiencing high anxiety with pressure from staff” it was alleged facility staff bring unnecessary anxiety onto R1 by continuously rejecting R1’s rent payment. R1 reported they received a rent increase from $1,779.75 to $4,500.00 effective January 2024. R1 added they refused to pay the facility for the rent increase. R1 reported they attempted to continue paying $1,779.75 per month and the facility rejected R1’s checks for the months of February and March 2024 because they do not accept partial payments, which brings unnecessary anxiety onto R1. Administrator Williams reported the facility does not accept partial payments and residents who do not pay their monthly rent for the basic service rate are served with eviction notices due to non-payment. Administrator Williams added the facility operates in good faith and is not serving eviction notices or operating with the intent to bring anxiety onto any resident.

Regarding the allegation, “Residents receiving SSI are being charged 2x-3x times more than the standard allowed rate” it was alleged residents that are Supplemental Security Income (SSI) recipients received rent increases that exceed the standard SSI rate. The Department did not receive specific names therefore 73 resident files were reviewed. Of the 73 files reviewed, 43 residents were identified as SSI recipients. Of the 43 SSI recipients, the Department selected a random sample of eighteen (18) to interview. Six (6) interviews were unsuccessful due to residents not being available. Of the twelve (12) remaining selected residents, five (5) residents reported they did not handle their finances and/or were unaware how much money is paid to the facility. Seven (7) residents interviewed, reported they are not paying more than the standard allowed rate.

Although the allegations may have happened or are valid, there is no preponderance of evidence to prove the alleged violations did or did not occur; therefore, the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to Administrator Williams.

*This is an amended version of the original report

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janette Romero	TELEPHONE: (951) 529-2930
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2024

LIC9099 (FAS) - (06/04)

Page: 4 of 4