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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336411384
Report Date: 03/20/2024
Date Signed: 03/20/2024 03:22:48 PM

Substantiated


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
02/28/2024 and conducted by Evaluator Sara Martinez
COMPLAINT CONTROL NUMBER: 18-AS-20240228101731
FACILITY NAME:ALPHA CHRISTIAN HOMESFACILITY NUMBER:
336411384
ADMINISTRATOR:AURELIO P. BESINAFACILITY TYPE:
735
ADDRESS:3542 RANCH STREETTELEPHONE:
(951) 435-7038
CITY:PERRISSTATE: CAZIP CODE:
92571
CAPACITY:6CENSUS: 3DATE:
03/20/2024
UNANNOUNCEDTIME BEGAN:
02:24 PM
MET WITH:Jorgena Lavarez - House Manager TIME COMPLETED:
03:32 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff refused to accept resident back from hospital
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Sara Martinez conducted an unannounced visit to deliver findings regarding the allegation listed above. LPA was granted entry and met with House Manager Jorgena Lavarez, who was Informed of the purpose of the visit.

Regarding the allegation “Facility staff refused to accept resident back from hospital” it was reported the facility refused to allow Client One (C1) back into the home after being sent to the hospital. Licensee Marlita Jimenez stated she received a phone call from Inland Regional Center (IRC) regarding an emergency placement needed for C1. Licensee accepted the emergency placement and picked C1 up from their home on 02.26.2024. Licensee stated IRC only provided C1’s Individual Program Plan (IPP) and did not have an admission’s agreement signed at that time. Licensee stated she looked over C1's IPP and agreed to admit C1 into the facility.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Sara Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
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 3
Control Number 18-AS-20240228101731
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: ALPHA CHRISTIAN HOMES
FACILITY NUMBER: 336411384
VISIT DATE: 03/20/2024
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
 Licensee stated that C1 had a walker to ambulate but when they arrived at the facility it was revealed that C1 needed more assistance from staff to ambulate due to C1’s condition. On the morning of 02.27.2024, the facility called 911 due to C1 verbalizing back pain and not being able to get out of bed on their own. C1 was taken to the hospital on 02.27.2024 and was ready for discharge the same day in the afternoon at approximately 4pm. Licensee contacted Community Care Licensing Riverside Office on 02.27.2024 and left a voicemail at 4:50pm inquiring if the facility can admit a client who uses a walker to ambulate but cannot stand on their own for an extended period of time due to facility being licensed for ambulatory clients only. Licensee informed the hospital's social worker that they were not licensed to admit C1 due to C1’s physical condition and they were not going to accept C1 back into the facility. Interview with IRC case worker for C1 revealed the intention of the emergency placement for C1 was to find a permanent residence at the facility. Therefore, based on interviews the allegation “Facility staff refused to accept resident back from hospital” has been deemed substantiated at this time.

A finding that the complaint is SUBSTANTIATED means the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated means that the allegation is valid. A citation is being issued in accordance with the California Code of Regulations (Title 22, Division 6, Chapter 3) on the attached 9099D.

An exit interview was conducted, and a copy of this report was given to Lavarez along with the LIC 9099-D, LIC 811, and appeal rights.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Sara Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20240228101731
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: ALPHA CHRISTIAN HOMES
FACILITY NUMBER: 336411384
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/21/2024
Section Cited
CCR
80072(a)(3)
1
2
3
4
5
6
7
Personal Rights (a) Except...each client shall have personal rights.. (3) To be free from corporal or unusual punishment, infliction of pain, humiliation...interference with the daily living functions, including eating, sleeping, or toileting; or withholding of shelter…This requirement was not being met as evidenced by:
1
2
3
4
5
6
7
Licensee agrees to review Title 22 Regulation sections 80072 and 80068.5 regarding Personal Rights and Eviction Procedures.Licensee confirmed with IRC they have found C1 a new placement to live.
8
9
10
11
12
13
14
Based on interview with Licensee, Licensee did not ensure resident was accepted back into the facility after hospitalization after excepting client into their facility for an emergency placement.This presents an immediate personal rights and safety risk to client in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Sara Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3