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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880982
Report Date: 11/18/2024
Date Signed: 11/18/2024 11:12:31 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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
06/13/2024 and conducted by Evaluator Mary Rico
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240613101133
FACILITY NAME:PARKVIEW RESIDENTIAL CAREFACILITY NUMBER:
331880982
ADMINISTRATOR:DURRANI, SULAIMANFACILITY TYPE:
735
ADDRESS:102 PARKVIEW DRIVETELEPHONE:
(714) 854-5596
CITY:CALIMESASTATE: CAZIP CODE:
92320
CAPACITY:4CENSUS: 1DATE:
11/18/2024
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Staff- Jason CamTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff did not provide a safe and healthful environment for client.
Staff did not assist with clients' hygiene care needs.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to investigate and deliver findings on the allegations listed above. LPA met with staff Jason Cam and explained the purpose of the visit. The Administrator Sulaiman Durrani was contact and inform regarding today’s visit. The investigation consisted of staff interviews, client interviews and record review.

For the allegation, Staff did not provide a safe and healthful environment for client.

During staff interviews 2 out of the 2 staff stated they provide a safe and healthful environment for clients. In addition, 2 out of the 2 staff also stated they lock all chemicals, medications, and knife/sharp items. During client interview, 1 out of the 1 client stated they feel safe at the facility.

During facility tour, LPA observed chemicals, knifes and medications locked inaccessible for clients in care.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2024
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 2
Control Number 56-AS-20240613101133
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: PARKVIEW RESIDENTIAL CARE
FACILITY NUMBER: 331880982
VISIT DATE: 11/18/2024
NARRATIVE
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For the allegation, Staff did not assist with clients’ hygiene care needs.

During staff interviews, 2 out of the 2 staff stated they will assist with clients’ hygiene care. 2 out of the 2 staff also stated they will ensure their client has good hygiene care in the morning and before bed. During client interview, 1 out of the 1 client stated they do not require assistance with their ADLS, but when needed staff are willing to assist.

During record review, C1 Physician Report indicated client is capable of self-care.

Based on the evidence found during the investigation, the two (2) allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.


An exit interview was conducted, and this report (LIC9099) was discussed and provided to staff Jason Cam.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2