336425525-9-2-2021-18-AS-RLAY-C8ZPH9-20211122101930

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336425525
Report Date: 09/02/2021
Date Signed: 09/02/2021 04:14:30 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
06/30/2020 and conducted by Evaluator Deborah Mullen

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20200630111033

FACILITY NAME:	SUNNY ROSE GLEN		FACILITY NUMBER:	336425525
ADMINISTRATOR:	ARANZAZU LAMB		FACILITY TYPE:	740
ADDRESS:	29620 BRADLEY RD		TELEPHONE:	(951) 679-3355
CITY:	MENIFEE	STATE: CA	ZIP CODE:	92586
CAPACITY:	81	CENSUS: 49	DATE:	09/02/2021
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Letty Martinez, Business Manager		TIME COMPLETED:	04:25 PM

ALLEGATION(S):

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Staff are not following food service regulations
Staff stole resident's medication.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Deborah Mullen conducted an unannounced visit to investigate the above allegations. LPA met with Letty Martinez, Business Manager. At the time of the visit four residents and three staff were interviewed and reviewed facility documentation.

The Department received information that staff do not provide an adequate amount of food for residents and that staff are not serving a variety of food.
4 out of 4 residents interviewed reported a good selection of food in ample quantity. Residents stated they are provided plenty of food and that there are always alternative items they can order if they don't want what is on the daily menu.

Unsubstantiated

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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Control Number 18-AS-20200630111033

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
RIVERSIDE, CA 92507

FACILITY NAME: SUNNY ROSE GLEN	FACILITY NUMBER: 336425525
	VISIT DATE: 09/02/2021

NARRATIVE

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The Department received information that staff stole a resident's medication. An interview with staff revealed a previous staff member (S1) was seen on camera pre-popping a narcotic medication of one of the residents medication but staff was never seen going into the room to administer the medication to the resident. S1 denied stealing medication when investigated by facility management staff.

Based upon interviews conducted and a review of facility documents obtained there is not enough evidence to state staff are not following food service regulations or that staff stole resident's medication. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report was reviewed with and provided to Letty Martinez.

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

LIC9099 (FAS) - (06/04)

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