336409394-10-31-2023-18-AS-JDHS-D33VC9-20240305151844

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336409394
Report Date: 10/31/2023
Date Signed: 10/31/2023 05:17:03 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
03/23/2022 and conducted by Evaluator Venus Mixson

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20220323154456

FACILITY NAME:	JONES ADULT CARE FACILITY I		FACILITY NUMBER:	336409394
ADMINISTRATOR:	DEBORAH L. COLLINS		FACILITY TYPE:	735
ADDRESS:	24211 FINLEY AVENUE		TELEPHONE:	(951) 247-1577
CITY:	MORENO VALLEY	STATE: CA	ZIP CODE:	92553
CAPACITY:	6	CENSUS: 3	DATE:	10/31/2023
		UNANNOUNCED	TIME BEGAN:	02:28 PM
MET WITH:	ADMINISTRATOR, DEBORAH COLLINS.		TIME COMPLETED:	05:28 PM

ALLEGATION(S):

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9

Staff yells at client.
Staff speaks inappropriately to client.
Staff prevents client from attending their scheduled therapy.

INVESTIGATION FINDINGS:

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On October 31, 2023, Licensing Program Analyst (LPA), Venus Mixson conducted a visit to the facility and met with Administrator, Deborah Collings. The visit was conducted in order to provide findings for the investigation pertaining to the listed allegations. The investigation consisted of interviews, record reviews, and observations.

During the investigation the LPAs Interviewed the Administrator, staff/ residents and witnesses. The investigation consisted of interviews, record reviews, and observations made by the LPAs.

On March 23, 2022, Community Care Licensing (CCL) received information that stated staff yells at the client, staff speaks inappropriately to client, and staff prevents the client from attending scheduled therapy.

Regarding the allegation staff yells at client, the information obtained stated that R1 admitted the allegation was not true that she was frustrated because of all of the house rules. Additional, information obtained from interviews stated that R1 was rude to the facility staff and talked back on more than one occasion. There was not sufficient information to prove that this allegation occurred.

Regarding the allegation staff speaks inappropriately to the client, information obtained stated R1 was struggling with following the facility program including the house rules and there was other stuff going on with R1 not pertaining to the staff or the facility. Additional, information stated R1 took responsibility for not following the house rules, for talking back and for giving the facility staff a rough time. Information stated R1 got on track and completed the program. The information obtained does not corroborate the listed allegation.

Regarding the allegation staff prevents client from attending scheduled therapy, the information obtained stated, there were no documented reports to show that R1 missed any of the scheduled appointments, the facility did not receive any calls from any scheduled therapy appointments.

Based on interviews, record reviews and the LPA's observations the investigation findings have been deemed, "Unsubstantiated." An allegation finding of unsubstantiated means "although, the allegation may have happened or is valid, there is not a preponderance of the evidence strand to prove the alleged violations did or did not occur." Therefore, the allegations are deemed "unsubstantiated."

An exit interview was conducted and a copy of this report, along with the LIC 811, was given to the Administrator, Deborah Collins.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2023

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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