331880812-8-3-2021-18-AS-KCLS-C63RRJ-20210820131511

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880812
Report Date: 08/03/2021
Date Signed: 08/03/2021 03:10:46 PM

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
07/29/2021 and conducted by Evaluator Christine Le

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20210729084712

FACILITY NAME:	RIVERWALK VISTA SENIOR CARE LLC		FACILITY NUMBER:	331880812
ADMINISTRATOR:	VALENZUELA, MYRNA D		FACILITY TYPE:	740
ADDRESS:	10831 PORTOFINO LANE		TELEPHONE:	(951) 532-7746
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92503
CAPACITY:	6	CENSUS: 5	DATE:	08/03/2021
		UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Myrna Valenzuela		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Facility is not meeting the resident's needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christine Le conducted an unannounced visit to the facility to investigate the above allegation. LPA met with administrator Myrna Valenzuela.

LPA toured the facility, conducted interviews, and reviewed facility files. The allegation indicates that the facility is not meeting Resident 1 (R1)'s needs. The complaint alleged that the facility staff were not taking care of R1's hygiene needs which resulted in the resident's hair having dandruff and scalp issues. LPA conducted interviews with staff and residents. Interviews with staff denied that the resident sustained major dandruff and scalp issues. Facility staff assisted R1 with bathing everyday and washed his/her hair a few times a week. An interview with R1 denied that his/her hair had major dandruff and scalp issues while living at the facility. R1 stated that he/she has dandruff but it is mild and controlled at this time. LPA also showed an alleged photo of R1's hair to the staff and residents. Both the staff and R1 denied that the picture was R1's hair and denied that his/her hair was ever in that state at the facility. An interview with R1 reported in general the staff take good care of him/her and wash his/her hair on a regular basis. LPA also conducted

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Christine Le	TELEPHONE: (951) 897-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2021

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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Control Number 18-AS-20210729084712

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: RIVERWALK VISTA SENIOR CARE LLC	FACILITY NUMBER: 331880812
	VISIT DATE: 08/03/2021

NARRATIVE

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a health & safety check of the facility and observed R1 to be in a clean, safe, and healthful environment.

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.

No deficiencies were cited during this visit. An exit interview was conducted where this report was discussed and provided to the administrator.

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Christine Le	TELEPHONE: (951) 897-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2021

LIC9099 (FAS) - (06/04)

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