336409054-3-3-2022-18-AS-TDAN-D67NW2-20240613104850

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336409054
Report Date: 03/03/2022
Date Signed: 03/03/2022 01:32:44 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
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/03/2022 and conducted by Evaluator Jesse Gardner

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20220303094245

FACILITY NAME:	DIAMOND RCFE OF MURRIETA		FACILITY NUMBER:	336409054
ADMINISTRATOR:	IARISH MARTINEZ		FACILITY TYPE:	740
ADDRESS:	26973 HOLLYGROVE CT		TELEPHONE:	(951) 304-2162
CITY:	MURRIETA	STATE: CA	ZIP CODE:	92563
CAPACITY:	6	CENSUS: 5	DATE:	03/03/2022
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Agnes Martinez, Administrator		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee not meeting resident health needs

INVESTIGATION FINDINGS:

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2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Jesse Gardner conducted an unannounced visit to investigate the above allegation. LPA was greeted by Administrator Agnes Martinez, and allowed access into the facility.

After interviewing Resident 1 (R1), regarding the allegation, "Licensee is not meeting resident health needs", Licensee assessed R1's condition, and determined that they could not meet the needs the resident was facing at the time, and therefore needed to be transported to the hospital on varying dates. Thus, the above allegation was deemed to be UNSUBSTANTIATED.

No citations were observed. An exit interview was conducted, and a copy of this report, along with a copy of the LIC811 was provided to Ms. Martinez.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Deborah Mullen	TELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Jesse Gardner	TELEPHONE: (951) 205-2683
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

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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