331880774-9-21-2023-18-AS-JDHS-CW58YZ-20230928225645

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880774
Report Date: 09/21/2023
Date Signed: 09/21/2023 10:52:29 AM

Unfounded

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
09/19/2023 and conducted by Evaluator Javina George

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20230919085318

FACILITY NAME:	RAINCROSS AT RIVERSIDE		FACILITY NUMBER:	331880774
ADMINISTRATOR:	JUDITH PIERFAX		FACILITY TYPE:	740
ADDRESS:	5232 CENTRAL AVENUE		TELEPHONE:	(951) 785-1200
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92504
CAPACITY:	120	CENSUS: 82	DATE:	09/21/2023
		UNANNOUNCED	TIME BEGAN:	08:56 AM
MET WITH:	Judith Perfax, Exectuive Director		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Staff do not properly monitor a resident's incontinence needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to commence a complaint investigation in regards to allegation noted above. LPA met with Executive Director Judith Pierfax and explained the purpose of the visit and the elements of the investigation. The allegation was investigated and consisted of observations, interviews and records review.

It was alleged that staff do not properly monitor Resident #1 (R1) incontinent needs. R1 moved into the facility on July 31, 2023 and resides in assisted living. Per the initial assessment completed R1 was not identified as having any incontinent needs. Per an interview with Executive Director Judith, they were making their rounds on or around 09/04/23, and observed for there to be a urine odor coming from R1's laundry. As a result R1's responsible party was contacted, and resulted in a care conference being held on 09/06/23. Resident Care Director William Lewallen and R1's responsible parties were present and observations and concerns were discussed regarding R1 not bathing, changing their clothes and properly washing their clothes.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Javina George	TELEPHONE: (951) 204-7107
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023

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-20230919085318

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: RAINCROSS AT RIVERSIDE	FACILITY NUMBER: 331880774
	VISIT DATE: 09/21/2023

NARRATIVE

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A reassessment was completed during the care conference, and the facility has intervened and has implemented washing R1's clothes for them, moved R1's shower time to the AM instead of the PM, as well as lay out R1's clothes for the day. The facility is currently in the process of arranging a follow up meeting to see what has been working and if any adjustments are needed to see what will work best for R1. The facility staff observed there was a need and action was taken to address R1s needs, based on interviews and records review the allegation is UNFOUNDED. A finding that the complaint is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

An exit interview was conducted and a copy of this report was provided to Judith Pierfax, Executive Director.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Javina George	TELEPHONE: (951) 204-7107
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023

LIC9099 (FAS) - (06/04)

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