331880776-2-1-2023-18-AS-DMUN-CNWRWB-20230210122251

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880776
Report Date: 02/01/2023
Date Signed: 02/01/2023 10:46:32 AM

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
01/30/2023 and conducted by Evaluator Jesse Gardner

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20230130142250

FACILITY NAME:	WESTMONT VILLAGE		FACILITY NUMBER:	331880776
ADMINISTRATOR:	VIVIAN VILLEGAS		FACILITY TYPE:	740
ADDRESS:	17050 ARNOLD DRIVE		TELEPHONE:	(951) 697-2100
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92518
CAPACITY:	225	CENSUS:	DATE:	02/01/2023
		UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Angel Melendez, Receptionist		TIME COMPLETED:	10:55 AM

ALLEGATION(S):

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Staff do not provide proper medication assistance to resident in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jesse Gardner made an unannounced visit to investigate the above allegation. LPA arrived at the facility, and met with Receptionist Angel Melendez and LPA explained the purpose of the visit. LPA toured the facility. LPA later met with Resident Services Director Mayra Alfaro, and Memory Care Resident Services Director Emerald Mobley.

It was alleged that Resident One (R1) was not receiving their medication, as ordered by their physician. Regarding the allegation, "Staff do not provide proper medication assistance to resident in care", LPA conducted interviews with R1, and staff. Through interviews with staff and an outside witness, LPA found that the facility had contacted the doctor's office and the prescription was ordered 1/23/23. R1's doctor's office sends the medication through CVS Care Mark, and due to the medication being a narcotic, it is sent via mail. R1 has not received the medication, as of yet; however, through interviews with staff and R1, R1 was offered alternative pain medications, as well as hospitalization if R1 required. Thus, LPA found that the allegation was UNSUBSTANTIATED. A finding of UNSUBSTANTIATED means that 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 where a copy of this report was discussed with and provided to Resident Services Director Mayra Alfaro.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Deborah Mullen	TELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Jesse Gardner	TELEPHONE: (951) 205-2683
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

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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