336423972-6-11-2020-18-AS-KCLS-BQMTXK-20200616150715

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336423972
Report Date: 02/04/2020
Date Signed: 06/11/2020 04:37:24 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
01/28/2020 and conducted by Evaluator Javier Prieto

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20200128151100

FACILITY NAME:	WHITE'S LOVE & CARE RESIDENTIAL ELDERLY HOME INCII		FACILITY NUMBER:	336423972
ADMINISTRATOR:	JACQUELYN J. WHITE		FACILITY TYPE:	740
ADDRESS:	24068 RISTRAS LANE		TELEPHONE:	(951) 319-6622
CITY:	MURRIETA	STATE: CA	ZIP CODE:	92562
CAPACITY:	6	CENSUS: 4	DATE:	02/04/2020
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Jacquelyn White		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Facility staff speak inappropriately to resident

Facility staff did not safeguard resident's property

Facility staff did not allow resident to review their records

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Javier Prieto contacted the facility, via telephone and email, due to COVID-19 social distancing, to conduct a complaint investigation. LPA Prieto identified himself, communicated with facility Administrator Jacquelyn White, and discussed the purpose of the call and the elements of the complaint with allegations that the facility staff speak inappropriately to resident, facility staff did not safeguard resident's property and facility staff did not allow resident to review their records. R1 states R1 did not ask to review R1's records and stated that staff does not speak to R1 in appropriately. R1 recalls that personal property (Endure drink), was in R1's possession. Staff denies speaking to R1 inapproproately and confirmed by R1. Staff produced R1's property to LPA and confirmed by R1. Staff states R1 did not ask to see their records, but a request from an unauthroized agency. Staff attempts to protect R1's confidential records.
Based on the information obtained there is not enough evidence that facility staff speak inappropriately to resident, facility staff did not safeguard resident's property and facility staff did not allow resident to review their records . Therefore, the allegations is deemed UNSUBSTANTIATED at this time. 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, therefore the allegation is UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Javier Prieto	TELEPHONE: 951-217-3135
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020

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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