336423576-3-7-2025-56-AS-EMAN-DEYP4T-20250321105940

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336423576
Report Date: 03/07/2025
Date Signed: 03/07/2025 04:30:15 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
01/22/2025 and conducted by Evaluator Raquel Hernandez

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20250122085002

FACILITY NAME:	PEACEFUL LIVING #2		FACILITY NUMBER:	336423576
ADMINISTRATOR:	RUSH, JOE		FACILITY TYPE:	735
ADDRESS:	1112 PEACEFUL DRIVE		TELEPHONE:	(951) 531-8134
CITY:	CORONA	STATE: CA	ZIP CODE:	92880
CAPACITY:	6	CENSUS: 4	DATE:	03/07/2025
		UNANNOUNCED	TIME BEGAN:	02:40 PM
MET WITH:	Administrator Lena Rush		TIME COMPLETED:	04:40 PM

ALLEGATION(S):

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Staff hit the clients while in care
Staff pulled a client's hair while in care
Staff did not keep the facility free from rodents
Staff does not properly maintain the facility
Staff does not ensure the home has food for the clients

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Raquel Hernandez conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Administrator Lena Rush and explained the purpose of the visit. The investigation consisted of client interviews and facility tour.

For the allegation, Staff hit the clients while in care.

LPA Hernandez conducted (4) client interviews. 4 out of the 4 clients stated facility staff have not hit them or have witnessed facility staff hit any of the clients in care. LPA Hernandez conducted (2) staff interviews. 2 out of the 2 staff stated they have not hit any clients in care nor have witnessed any other staff hit any of the clients in care.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2025

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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Control Number 56-AS-20250122085002

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: PEACEFUL LIVING #2	FACILITY NUMBER: 336423576
	VISIT DATE: 03/07/2025

NARRATIVE

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For the allegation, Staff pulled a client's hair while in care.

LPA Hernandez conducted (4) client interviews. 3 out of the 4 clients stated facility staff have never pulled their hair nor have witnessed facility staff pull any of the client's hair. 1 out of the 4 clients stated a former staff did pull their hair but was unsure on when this occurred. LPA Hernandez conducted (2) staff interviews. 2 out of the 2 staff stated they have never pulled a client's hair nor witnessed other facility staff pull any of the clients hair.

For the allegation, Staff did not keep the facility free from rodents.

LPA Hernandez conducted (4) client interviews. 4 out of the 4 clients stated they have not seen any rodents at the facility. LPA Hernandez conducted (2) staff interviews. 2 out of the 2 staff stated they have not seen or heard of any rodents being seen at the facility. Additionally, LPA Hernandez observed facility to be free from rodents and any rodent traps.

For the allegation, Staff does not properly maintain the facility.

LPA Hernandez conducted (4) client interviews. 4 out of the 4 clients stated the facility is always clean. LPA Hernandez conducted (2) staff interviews. 2 out of the 2 staff stated the facility is cleaned everyday.

For the allegation, Staff does not ensure the home has food for the clients.

LPA Hernandez conducted (4) client interviews. 4 out of the 4 clients stated the facility always has enough food for clients in care. LPA Hernandez conducted (2) staff interviews. 2 out of the 2 staff stated the facility always has food available for clients in care. LPA Hernandez observed non-perishable and perishable food supply is sufficient for number of clients in care.
Based on the evidence gathered during today’s investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC9099) was discussed and provided to Administrator Lena Rush.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2025

LIC9099 (FAS) - (06/04)

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