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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336423469
Report Date: 09/12/2024
Date Signed: 09/12/2024 02:23:04 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
, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/06/2024 and conducted by Evaluator Bernadette Allen
COMPLAINT CONTROL NUMBER: 56-AS-20240906165654
FACILITY NAME:NEW DISCOVERY RESIDENTIAL SERVICES #4FACILITY NUMBER:
336423469
ADMINISTRATOR:DONNA WELDONFACILITY TYPE:
735
ADDRESS:903 UNION ST.TELEPHONE:
(951) 381-4130
CITY:BEAUMONTSTATE: CAZIP CODE:
92223
CAPACITY:4CENSUS: 3DATE:
09/12/2024
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Vivian Francisco-Acting AdministratorTIME COMPLETED:
02:35 PM
ALLEGATION(S):
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Staff do not provide adequate food service for residents
Staff do not safeguard resident's personal items
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bernadette Allen and Lavette Farlow made an unannounced visit to the facility to conduct complaint investigation and deliver findings. LPAs identified themselves and informed Vivian Francisco acting administrator of the purpose of the visit and allegations.

The investigation consisted of interviewing staff, residents, record review, and a tour of the facility. LPAs observed each resident’s bedroom which has personal items hanging in their closets and clothing in their drawers that has their names or initials. LPAs also observed a logbook with pictures of each residents’ personal items. The administrator has also taken precaution to safeguard residents’ personal items by changing doorknobs that require a key to enter rooms if locked. The staff were interviewed and stated Resident 1 (R1) has taken other residents clothing in the past but preventative measures have been taken to avoid further incidents. LPAs observed staff preparing lunch upon our arrival. LPAs observed a variety of perishable and nonperishable food items for residents in care. The facility menu was available for review, and it appeared that food is prepared based on the menu with allowed options.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
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 2
Control Number 56-AS-20240906165654
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME: NEW DISCOVERY RESIDENTIAL SERVICES #4
FACILITY NUMBER: 336423469
VISIT DATE: 09/12/2024
NARRATIVE
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Based on interviews, documentation, and observations the above findings are Unsubstantiated. A finding of unsubstantiated means although the allegations 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 provided to Vivian Francisco Administrator at the conclusion of the visit with the appeal rights.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2