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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336423576
Report Date: 03/25/2024
Date Signed: 03/25/2024 01:08:25 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO 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
03/19/2024 and conducted by Evaluator Bianca Wolcott
COMPLAINT CONTROL NUMBER: 56-AS-20240319104419
FACILITY NAME:PEACEFUL LIVING #2FACILITY NUMBER:
336423576
ADMINISTRATOR:RUSH, JOEFACILITY TYPE:
735
ADDRESS:1112 PEACEFUL DRIVETELEPHONE:
(951) 531-8134
CITY:CORONASTATE: CAZIP CODE:
92880
CAPACITY:6CENSUS: 4DATE:
03/25/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Lena Rush/AdministratorTIME COMPLETED:
01:11 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff physically assaulted a client.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Bianca Wolcott met with Licensee/Administrator Lena Rush at facility and explained reason for visit for the allegation listed above. The investigation consisted of interviews and review of pertinent documentation's.

For the allegation, Staff physically assaulted a client.

During staff interviews, 3 out of the 3 Staff stated they have never assaulted a client. In addition, no staff has witnessed any staff and residents having any altercation before, nor any bruising from altercations with staff.

During resident’s interviews, 2 out of 2 residents stated staff have never physically assaulted. In addition, resident's stated staff has never been aggressive with towards them or grabbed them in anyway before. The two residents also stated staff has never asked residents to move out of the facility.

Based on the information revealed during the investigation, LPA Wolcott did not find evidence to corroborate the allegation, these allegations are therefore unsubstantiated. A finding of UNSUBSTANTIATED means, although the allegation 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 with Administrator, and a copy of this report was provided to Administrator.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Bianca Wolcott
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2024
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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