336407734-4-26-2024-18-AS-TDAN-D5PU9L-20240528152319

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336407734
Report Date: 04/26/2024
Date Signed: 04/26/2024 11:13:07 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
04/22/2024 and conducted by Evaluator Janira Arreola

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20240422165732

FACILITY NAME:	PICO DE LORO		FACILITY NUMBER:	336407734
ADMINISTRATOR:	VIVIEN RILLO/EFREN RILLO		FACILITY TYPE:	740
ADDRESS:	620 NORTH PERRIS BLVD		TELEPHONE:	(951) 943-8081
CITY:	PERRIS	STATE: CA	ZIP CODE:	92571
CAPACITY:	43	CENSUS: 38	DATE:	04/26/2024
		UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:			TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff left residents alone without adequate supervision
Staff did not keep the facility clean or sanitary
Staff did not ensure that residents were adequately fed

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 Administrator, Efren Rillo 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 "Staff left residents alone without adequate supervision", and there was no staff at the facility. It was alleged that on 4/22/2024 at 10:30am there were no staff at the facility. LPA conducted a records review of the staff schedule for Monday 4/22/2024 and found there were (9) staff working at the facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janira Arreola	TELEPHONE: 951-233-6759
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024

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-20240422165732

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: PICO DE LORO	FACILITY NUMBER: 336407734
	VISIT DATE: 04/26/2024

NARRATIVE

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LPA conducted interviews with (4) staff scheduled on Monday 4/22/2024, who denied there was no staff working on this date. Around 10:30am, staff reported activities are taking place at the facility, and staff are walking around to ensure residents in their rooms are supervised. LPA conducted (4) resident interviews which revealed that staff come and assist the residents and check on them. During today’s visit LPA was at the facility from 8:40am to 11:30am and observed staff was present in the kitchen, resident rooms, and common areas. Therefore, based on interviews, records review and observation the allegation that no staff were present at the facility on Monday 4/22/2024 is unsubstantiated.

It was alleged that "Staff did not keep the facility clean or sanitary". LPA conducted a walk through of the facility, including common areas, kitchen, resident rooms, bathrooms, and outdoor area. LPA observed the facility was clean and sanitary. LPA observed the cleaning supplies the facility utilizes to conduct regular cleaning of the facility, as well as hygiene and incontinent supplies for residents. LPA conducted (6) staff interviews, which revealed conflicting information. (1) staff interview revealed housekeeping staff do not always keep the facility clean, however (5) staff reported the facility is kept clean and all staff work together to help keep it clean. LPA conducted (4) resident interviews which revealed that staff keep their rooms clean and conduct laundry regularly. Therefore, based on interviews and observations LPA found that the allegation is unsubstantiated.

It was alleged that "Staff did not ensure that residents were adequately fed", and facility residents appeared to be malnourished and “drugged”. LPA conducted a tour of the facility including the common areas, resident rooms and bathrooms, and outdoor areas. LPA found observed residents engaging in activities, and in their rooms. No health or safety issues were observed concerning the care of the residents. LPA also reviewed the facility menu, and conducted a walk through of the facility kitchen and found the facility meets the required food supply. LPA conducted (6) staff interviews who denied that residents are malnourished and being fed. LPA conducted (4) resident interviews which revealed that residents are being fed and there is enough food for the residents. Therefore, based on interviews, records review and observations, LPA found the allegation is 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 with Administrator, Efren Rillo where this report was reviewed and provided to them.

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janira Arreola	TELEPHONE: 951-233-6759
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024

LIC9099 (FAS) - (06/04)

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