331881130-7-26-2023-18-AS-RSTS-CZN3BK-20240119170630

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331881130
Report Date: 07/26/2023
Date Signed: 07/26/2023 11:04:35 AM

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
07/18/2023 and conducted by Evaluator Jesse Gardner

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20230718155629

FACILITY NAME:	C & M COMFORT HOME		FACILITY NUMBER:	331881130
ADMINISTRATOR:	COURT, CHRISTIAN		FACILITY TYPE:	735
ADDRESS:	24662 MANTEE PLACE		TELEPHONE:	(951) 378-5820
CITY:	MORENO VALLEY	STATE: CA	ZIP CODE:	92553
CAPACITY:	6	CENSUS: 2	DATE:	07/26/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Christian Court, Administrator		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Staff is verbally abusing a resident while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jesse Gardner arrived unannounced at the facility to commence a complaint investigation for the allegation listed above. LPA Gardner identified himself and discussed the purpose of the visit with Administrator Christian Court (S1).

LPA toured the facility, conducted client, and staff interviews. At the conclusion of the tour, LPA found that residents do have working utilities, and an adequate food supply. It was alleged that staff were verbally abusive to a resident while in care as reported by an incident to allegedly occur on 7/18/23. LPA conducted interviews with several residents, and staff, and found that through those interviews, to include a resident who was allegedly involved with staff yelling at them, LPA concluded that there was no recollection of the incident, nor were there any concerns of staff yelling or verbally abusing residents, otherwise. Therefore, 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 Administrator Christian Court.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2023

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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