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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881503
Report Date: 03/28/2024
Date Signed: 03/28/2024 11:57:41 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
03/22/2024 and conducted by Evaluator Crystal Colvin
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240322164453
FACILITY NAME:TRANQUIL SPRINGS CRTFACILITY NUMBER:
331881503
ADMINISTRATOR:BLUM, CHRISTOPHERFACILITY TYPE:
772
ADDRESS:47915 OASIS ST STE CTELEPHONE:
(442) 282-4909
CITY:INDIOSTATE: CAZIP CODE:
92201
CAPACITY:15CENSUS: 15DATE:
03/28/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Elizabeth Ross - AdministratorTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Facility is not meeting the needs of a resident in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Crystal Colvin conducted an unannounced visit to the facility for the purpose of conducting a complaint investigation for the above allegation. LPA Colvin met with Administrator Elizabeth Ross and advised her of the purpose of today's inspection. Below is a summary of the investigation.

Regarding allegation "Facility is not meeting the needs of a resident in care": LPA Colvin interviewed staff and resident(s) related to the complaint as well as reviewed resident file(s). LPA Colvin observed that the primary complaint was that the resident(s) was not provided with adequate housing resources for their transition out of the facility as well as their mental health needs were not being met. LPA Colvin confirmed through interview and record review that the resident (R1) was offered multiple housing options and facility staff assisted R1 with touring the locations and obtaining applications, but R1 rejected these options for various reasons. LPA Colvin additionally observed records of mental health treatment provided to R1 during their 30-day stay at the facility, which included individual therapy and group therapy sessions.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024
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 18-AS-20240322164453
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: TRANQUIL SPRINGS CRT
FACILITY NUMBER: 331881503
VISIT DATE: 03/28/2024
NARRATIVE
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LPA Colvin notes that this facility's goal is for short-term stays to transition residents from in-patient psychiatric holds and is not set up to be for long-term care. LPA Colvin observed that the facility created a Needs & Services Plan for R1 and provided for the needs & services addressed in said plan, as well as for what was agreed upon in the Admissions Agreement. Therefore, due to the evidence provided to LPA Colvin, the allegation "Facility is not meeting the needs of a resident in care" is UNSUBSTANTIATED.

A finding of UNSUBSTANTIATED means 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 with Administrator Elizabeth Ross and a copy of this report was provided.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2