335530032-2-14-2023-56-AS-KCLS-CP5TNL-20230217135256

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 335530032
Report Date: 02/14/2023
Date Signed: 02/14/2023 01:19:17 PM

Unsubstantiated

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
02/09/2023 and conducted by Evaluator Javier Prieto

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20230209131116

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: 92	DATE:	02/14/2023
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Katherine Trevino, Director		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff is financially abusing resident
Staff do not accord resident privacy.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Javier Prieto and LPA Magda Malcore arrived to the facility to conduct a complaint investigation regarding the above mentioned allegations and met with Director Trevino to discuss the elements of the complaint. LPA Prieto interviewed client #1 (C1) in question who stated he does not know anything about a staff financially abusing him and does not remember any staff asking for money or borrowing any money from C1. C1 also understands that staff enters C1's room in order for staff to clean the rooms and collect clothing and bedsheets for laundry. C1 is aware that staff enter to room, to provide these service while C1 is not at the facility.

Based on the information obtained there is not enough evidence that staff is financially abusing resident and
staff do not accord resident privacy. Therefore, the allegations are is deemed UNSUBSTANTIATED at this time. 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, therefore the allegation is UNSUBSTANTIATED.

Unsubstantiated

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: 02/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

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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