336403045-12-20-2023-18-AS-RSTS-CYS25X-20231222160616

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336403045
Report Date: 12/20/2023
Date Signed: 12/20/2023 05:32:54 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
10/20/2023 and conducted by Evaluator Sara Martinez

COMPLAINT CONTROL NUMBER: 18-AS-20231020101053

FACILITY NAME:	MAJESTY VILLAGE		FACILITY NUMBER:	336403045
ADMINISTRATOR:	ALMA TUSCANO		FACILITY TYPE:	735
ADDRESS:	8595 PHILBIN AVENUE		TELEPHONE:	(951) 509-6826
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92503
CAPACITY:	80	CENSUS: 75	DATE:	12/20/2023
		UNANNOUNCED	TIME BEGAN:	05:12 PM
MET WITH:	Administrator - Alma Tuscano		TIME COMPLETED:	05:42 PM

ALLEGATION(S):

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Staff did not ensure clients personal belongings were secured

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sara Martinez conducted an unannounced visit to conclude and deliver findings to an investigation regarding the above allegation. LPA was granted entry and met with Administrator Alma Tuscano. LPA conducted a tour of the facility and conducted interviews and record review.

Regarding the allegation “Staff did not ensure clients personal belongings were secured” it was alleged Client One (C1) had their personal property and valuables stolen at the facility. LPA interviewed Administrator Tuscano regarding Client One (C1) and their personal belongings while living at the facility. LPA requested to see an inventory list for C1’s belongings upon move-in date 01/13/2021. LPA was informed that an inventory list was not available for review due to C1’s personal property not being recorded on or after C1’s move-in date. Administrator stated the facility began to maintain records of clients’ personal property in January 2022 and provided C1’s inventory list dated 02/03/2022. Administrator stated clients have a key to their own apartment to secure and safeguard their property.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Sara Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023

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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Control Number 18-AS-20231020101053

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: MAJESTY VILLAGE	FACILITY NUMBER: 336403045
	VISIT DATE: 12/20/2023

NARRATIVE

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Record review of the admissions agreement signed by C1 and C1’s responsible party states that “the licensee will not be responsible for any personal property/valuables brought into the facility unless these items are entrusted to the administrator…Personal property inside the client’s room shall be the client’s responsibility”. Record review of C1’s Physician’s Report is marked C1 is able to manage their own cash resources. Record review of the facility’s Plan of Operations submitted to the Department under “Procedures for Client Admission” state “Personal property brought into the facility must be inventoried…and date-signed by the client and facility staff…”. C1’s responsible party stated the client’s personal belongings not secured were “blankets and undergarments" but C1’s responsible party is not aware if those items were entrusted to the administrator to be secured due to the amount of time passed from the initial move-in date. Record review and interviews provide no information that could corroborate or refute validity of the allegation. Therefore, based on interviews and record review the allegation “staff did not ensure clients personal belongings were secured” is deemed UNSUBSTANTIATED at this time.

A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted where this report and LIC811 was reviewed and provided to Administrator Alma Tuscano.

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Sara Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023

LIC9099 (FAS) - (06/04)

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