<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336408317
Report Date: 02/16/2024
Date Signed: 02/16/2024 11:26:38 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
02/14/2024 and conducted by Evaluator Crystal Colvin
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240214101105
FACILITY NAME:ANGELVIEW CARE HOMES, INC. @ SHORELINEFACILITY NUMBER:
336408317
ADMINISTRATOR:FAITH AUMENTADO, R.N.FACILITY TYPE:
735
ADDRESS:25830 SHORELINE STREETTELEPHONE:
(951) 485-8065
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92551
CAPACITY:4CENSUS: 4DATE:
02/16/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:May Boco - AdministratorTIME COMPLETED:
11:45 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is allowing clients to wander away from the facility without supervision
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
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 May Boco and advised her of the purpose of today's inspection. Below is a summary of the investigation.

Regarding allegation "Facility is allowing clients to wander away from the facility without supervision": LPA Colvin conducted interviews with staff as well as reviewed relevant documents in Resident One's (R1) file. LPA Colvin observed that R1 has a behavior of opening the facility front door and wandering into the front yard. Interviews with staff state that they maintain visual contact of R1 during these behaviors, and that R1 stays in the front yard. Consumer Notes reviewed by LPA Colvin support these statements. LPA Colvin additionally observed that the facility has implemented other measures to help the staff ensure the safety of R1 and other residents, such as an alarm on the front door and cameras in the living room and outside the front of the facility. Based on the available evidence, the allegation "Facility is allowing clients to wander away from the facility without supervision" is UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2024
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-20240214101105
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: ANGELVIEW CARE HOMES, INC. @ SHORELINE
FACILITY NUMBER: 336408317
VISIT DATE: 02/16/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
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 May Boco and a copy of this report was provided.
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2