336413282-10-13-2021-18-AS-RLAY-C87UKG-20211027153906

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336413282
Report Date: 09/02/2021
Date Signed: 10/13/2021 04:35:23 PM

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
08/26/2021 and conducted by Evaluator Deborah Mullen

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20210826132116

FACILITY NAME:	TEMPLE COURT SENIOR CARE		FACILITY NUMBER:	336413282
ADMINISTRATOR:	ESTA HOBBS		FACILITY TYPE:	740
ADDRESS:	40009 TEMPLE CT.		TELEPHONE:	(951) 461-4750
CITY:	MURRIETA	STATE: CA	ZIP CODE:	92563
CAPACITY:	6	CENSUS: 5	DATE:	09/02/2021
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Esta Hobbs, Licensee		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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Staff are not following the proper Covid 19 protocols

INVESTIGATION FINDINGS:

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This is an amended report of the initial report issued 9/2/21. Licensing Program Analyst (LPA) Deborah Mullen conducted an unannounced visit to investigate the above allegation. LPA met with Esta Hobbs, Licensee. LPA interviewed Licensee, staff and attempted to interview resident.

The Department received information that staff were not following the proper protocol for Covid 19. Licensee and staff all stated visitors and staff must take temperature, wear a mask and do a symptom check prior to entering facility. A sign in sheet with temperatures and symptom check was provided to LPA. An interview was attempted with one resident but was unsuccessful due to residents cognitive abilities.

This agency has investigated the complaint alleging staff are not following the proper Covid 19 protocols. We have found that the complaint was unfounded, meaning that the allegations were false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint. An exit interview was conducted, and a copy of this report was reviewed with and provided to Esta Hobbs, Licensee.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 836-2784
LICENSING EVALUATOR NAME: Deborah Mullen	TELEPHONE: (951) 212-0616
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021

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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