335530032-1-30-2023-56-AS-KCLS-CNLVVR-20230131154645

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 335530032
Report Date: 01/30/2023
Date Signed: 01/30/2023 12:14:26 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

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

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/24/2023 and conducted by Evaluator Javier Prieto

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20230124114800

FACILITY NAME:	VILLA DE ANZA		FACILITY NUMBER:	335530032
ADMINISTRATOR:	PENDING		FACILITY TYPE:	740
ADDRESS:	5881 EL PALOMINO DRIVE		TELEPHONE:	(951) 683-3333
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92509
CAPACITY:	197	CENSUS: 96	DATE:	01/30/2023
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Katherine Trevino, Executive Director		TIME COMPLETED:	12:20 PM

ALLEGATION(S):

1
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9

Staff do not safeguard resident's personal items.

INVESTIGATION FINDINGS:

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13

Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint investigation regarding the above allegation. LPA met with Executive Director Katherine Trevino and explained the elements of the complaint. LPA interviewed client #1 (C1) in question who denies that staff have ever failed to safeguard any of her personal items. C1 states that a personal item has been used by a party that is not the facility or facility staff. C1 states that an allegation made against the facility related to not safeguarding her personal items are false. C1 states that she enjoys her stay at the faciilty and that staff address her concerns.

This agency has investigated the complaint allegation and we have found that the complaint was UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Javier Prieto	TELEPHONE: 951-217-3135
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2023

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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