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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881250
Report Date: 03/13/2024
Date Signed: 03/13/2024 04:27:43 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
03/05/2024 and conducted by Evaluator Janira Arreola
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240305092330
FACILITY NAME:HOME OF COMFORT LLCFACILITY NUMBER:
331881250
ADMINISTRATOR:VANESSA TAYLORFACILITY TYPE:
735
ADDRESS:26545 ROLAND ROADTELEPHONE:
(951) 987-6069
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY:4CENSUS: 4DATE:
03/13/2024
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Licensee, Tasha HawkinsTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff did not seek medical attention for resident in a timely manner.
Staff leave resident(s) unsupervised for an extended period of time.
Staff do not ensure that resident(s) are administered medications as prescribed.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Janira Arreola, conducted an unannounced visit to the facility in order to investigate the above allegations. LPA met with Licensee, Tasha Hawkins who was informed of the purpose of the visit.

During the visit, LPA conducted interviews, documented observations, and conducted records reviews. It was alleged that facility staff did not seek medical attention for Client #1 (C1) in a timely manner, in regards to C1 having (2) pink eyes. LPA observed C1 during the time of the visit and observed C1 does not have pink eyes. LPA also reviewed MARS log for month of February 2024 where C1 had been prescribed eye drops 2/5/2024 indicated to be given for (7) days. LPA interviewed (2) staff who corroborated that C1 had red eyes in February 2024, but no longer have an infection. LPA was unable to interview C1 due to being nonverbal. LPA interview (1) client which revealed that C1 did not have red eyes. Therefore, based on observation, interview and record review, the allegation is found to be unsubstantiated at this time.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024
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 4
Control Number 18-AS-20240305092330
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: HOME OF COMFORT LLC
FACILITY NUMBER: 331881250
VISIT DATE: 03/13/2024
NARRATIVE
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It was also alleged that staff leave clients unsupervised for extended periods of time, in regards to Client #2 (C2) being left in their room for prolonged period of time. During today's visit LPA observed that C2 was in the living area writing on a piece of paper. LPA conducted interviews with (2) clients who stated that C2 sometimes stays in their room and sometimes stays in the living area. LPA conducted (2) staff interviews which revealed that C2 has a television in their room and likes to stay in their room. C2 is encouraged to come out, but staff respect the client's right to remain in their room. No concerns were expressed to staff about C2 being in their room, and staff expressed doing regular checks on C2 when they are in their room. Therefore, based on interviews and observations, LPA found the allegation sot be unsubstantiated.

It was alleged that "Staff do not ensure that resident(s) are administered medications as prescribed." In regards to the staff not administering medications as prescribed to (3) clients. LPA checked medications and MARS sheets for all (3) residents, and found no error. (2) staff interviews were conducted which further corroborated this. Therefore, the allegation was also unsubstantiated.

Findings that are unsubstantiated mean that although the allegation is valid, the preponderance of the evidence standard has not been met. An exit interview was conducted where this report was reviewed and provided to Licensee, Tasha Hawkins.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4