331881122-8-16-2023-18-AS-MVAO-D2AVW5-20240209154723

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331881122
Report Date: 08/16/2023
Date Signed: 08/16/2023 01:47:32 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 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
08/10/2023 and conducted by Evaluator Chinwe Nwogene

COMPLAINT CONTROL NUMBER: 18-AS-20230810091710

FACILITY NAME:	EMERALD ROSE GARDEN INC.		FACILITY NUMBER:	331881122
ADMINISTRATOR:	NAVAREZ, JULIE C		FACILITY TYPE:	740
ADDRESS:	74560 CORAL BELLS CIR		TELEPHONE:	(909) 533-0642
CITY:	PALM DESERT	STATE: CA	ZIP CODE:	92260
CAPACITY:	6	CENSUS: 4	DATE:	08/16/2023
		UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Julie Navarez, Licensee		TIME COMPLETED:	01:55 PM

ALLEGATION(S):

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Staff did not provide modified diet as prescribed by resident's physician.
Staff did not keep accurate resident records.
Staff slapped resident’s face.
Staff yelled at resident.
Illegal eviction.

INVESTIGATION FINDINGS:

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On 8/16/2023, Licensing Program Analyst (LPA) Chinwe Nwogene conducted an unannounced visit to investigate the above allegation(s). LPA met with licensee, Julie Navarez who was informed of the purpose of the visit. During the investigation, staff, residents, hospice nurse and confidential witness was interviewed, resident and facility record was reviewed.
Regarding the allegation “Staff did not provide modified diet as prescribed by resident's physician”, staff was interviewed who stated facility is following the modified diet recommended by the hospice. Resident was interviewed who denied being on modified diet. Interview with hospice Nurse revealed a protein and high fiber diet was recommended for resident and so far, facility has been observed to be following the recommendation. Resident’s file was reviewed and revealed no documentation of resident being on special or modified diet. LPA reviewed Facility food menu and observed menu to be sufficient. Unsubstantiated.
Regarding the allegation “Staff did not keep accurate resident records”, it was alleged facility doesn’t keep records of resident’s blood sugar levels. Staff was interviewed who stated staff checks and documents residents blood sugar levels daily. Resident was interviewed who acknowledged checks blood sugar daily in the morning. Hospice was interviewed who stated facility checks and has a documentation of resident’s blood sugar levels. A witness was interviewed who acknowledged once requested for and received a record of resident’s blood sugar levels. LPA reviewed resident’s file and observed facility keeps a record of resident's blood sugar levels. Unsubstantiated.

Continue on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rikesha Stamps	TELEPHONE: (951) -24-0313
LICENSING EVALUATOR NAME: Chinwe Nwogene	TELEPHONE: (951) 202-2066
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

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-20230810091710

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: EMERALD ROSE GARDEN INC.	FACILITY NUMBER: 331881122
	VISIT DATE: 08/16/2023

NARRATIVE

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Continued from LIC9099.

Regarding the allegation “Staff slapped resident’s face”, Staff was interviewed who denied slapped resident. LPA inquired about the resident who was reported was slapped. Staff stated there is no former or current resident with such name residing at the facility. Residents were interviewed who denied being slapped. Unsubstantiated.

Regarding the allegation “Staff yelled at resident”, staff was interviewed who denied yelled at resident. Licensee was interviewed who acknowledged once raised her voice at resident because resident was rude and calling nurses inappropriate names. Licensee stated the resident’s family was immediately informed of the resident’s inappropriate behavior. Resident was interviewed who started slurring and mumbling words. LPA couldn’t determine what happened. LPA interviewed other residents who denied staff yelled at resident. Unsubstantiated.

Regarding the allegation “Illegal eviction”, staff was interviewed who stated resident requires a higher level of care than the facility could provide. Staff stated eviction letter was issued to resident on 8/8/2023 and the resident’s responsible party was notified. Resident’s responsible party acknowledged received the eviction notice. Unsubstantiated.

Based on interviews with staff, residents and confidential witness and facility and resident’s records review, there is not enough evidence to support the above allegation. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report was reviewed with and provided to Julie Navarez.

SUPERVISOR'S NAME: Rikesha Stamps	TELEPHONE: (951) -24-0313
LICENSING EVALUATOR NAME: Chinwe Nwogene	TELEPHONE: (951) 202-2066
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

LIC9099 (FAS) - (06/04)

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