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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336408402
Report Date: 12/30/2024
Date Signed: 12/30/2024 03:11:01 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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
03/27/2024 and conducted by Evaluator Magda Malcore
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240327130517
FACILITY NAME:JUDAH HOUSEFACILITY NUMBER:
336408402
ADMINISTRATOR:CASSANDRA KNIGHTENFACILITY TYPE:
735
ADDRESS:13400 CHAPARRAL ROADTELEPHONE:
(951) 378-3800
CITY:CABAZONSTATE: CAZIP CODE:
92230
CAPACITY:5CENSUS: 4DATE:
12/30/2024
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Raven JohnsonTIME COMPLETED:
03:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not ensure that resident's dental needs were met
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced visit to conduct a complaint investigation on the above allegation. LPA met with House Manager, Raven Johnson who was informed of today’s visit.

Regarding the allegation staff did not ensure that resident's dental needs were met, LPA interviewed staff #1 (S1), staff #2 (S2), staff #3 (S3), staff #4 (S4), resident #1 (R1), and Resident #2 (R2). Staff interviews reveal they do ensure resident's dental needs are being met. Resident interviews reveal that their dental needs are being met.

Based on LPA's observations and interviews the allegation above is Unsubstantiated; meaning that 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 where this report was discussed and a copy provided to the House Manager at the conclusion of the visit.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2024
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 1