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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880774
Report Date: 01/26/2022
Date Signed: 01/26/2022 02:25:34 PM

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
01/20/2022 and conducted by Evaluator Stephanie Torres
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20220120112944
FACILITY NAME:RAINCROSS AT RIVERSIDEFACILITY NUMBER:
331880774
ADMINISTRATOR:JUDITH PIERFAXFACILITY TYPE:
740
ADDRESS:5232 CENTRAL AVENUETELEPHONE:
(951) 785-1200
CITY:RIVERSIDESTATE: CAZIP CODE:
92504
CAPACITY:120CENSUS: 62DATE:
01/26/2022
UNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Judith Pierfax, Executive DirectorTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff are not following COVID-19 guidelines
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Stephanie Torres, conducted an unannounced visit to the facility to initiate the investigation into the above allegation. The LPA met with Executive Director (ED), Judith Pierfax, and informed her of the purpose of the visit.

Regarding the allegation, "Staff are not following COVID-19 guidelines," it was alleged facility staff are not following guidelines relating to COVID-19, including the wearing of Personal Protective Equipment (PPE) and a lack of supplies. On this visit the LPA toured the facility, conducted staff/resident interviews, reviewed records, and took copies of pertinent documentation. The LPA toured the facility and observed hand sanitizer, in addition to hand washing stations with soap and paper towels, available. Of the seven (7) interviews conducted, one (1) reported knowledge of staff not wearing their mask above their nose. Interview report staff quickly adjust their masks after being directed to do so. Interviews were conducted with residents who were previously COVID-19 positive and with the staff who cared for them. One (1) interview reported staff, on occasion, have entered into one (1) resident bedroom, shared by two (2) residents, without full PPE. No information was received to
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Stephanie TorresTELEPHONE: (951) 204-5924
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2022
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-20220120112944
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: 01/26/2022
NARRATIVE
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indicate this incident resulted in a threat to the health and safety of the residents in care. ED Pierfax was interviewed and reported designated staff are instructed to care for COVID-19 positives only; however, when there are staffing limitations these staff do assist residents who are negative. Therefore, due to a lack of information, this allegation is deemed UNSUBSTANTIATED at this time. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

This report was reviewed with Pierfax and a copy was provided.
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Stephanie TorresTELEPHONE: (951) 204-5924
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2