<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336426108
Report Date: 12/06/2021
Date Signed: 12/06/2021 01:58:09 PM

Substantiated


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
11/16/2021 and conducted by Evaluator Amy Goldenberg
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20211116083945
FACILITY NAME:FIRST STEP CORONAFACILITY NUMBER:
336426108
ADMINISTRATOR:QUIROGA, MICHELLEFACILITY TYPE:
775
ADDRESS:237 RIVER RDTELEPHONE:
(951) 371-5593
CITY:CORONASTATE: CAZIP CODE:
92880
CAPACITY:75CENSUS: DATE:
12/06/2021
UNANNOUNCEDTIME BEGAN:
01:30 AM
MET WITH:Sophie Ponce, Program SupervisorTIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
-Facility kitchen sink not maintained in working order
-Facility water temperature not maintained within required temperature range
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
This unannounced visit conducted by Amy Goldenberg, Licensing Program Analyst (LPA), is being conducted to conclude this agency’s investigation into the complaint allegations mentioned above. LPA met with Sophie Ponce, Program Supervisor.

During the course of the investigation, interviews were conducted with seven (7) staff and a tour of the entire facility was conducted which included restrooms, changing areas, review of supplies for food and for incontinent care, assessing the condition of the kitchen sink, checking enterances and walkways for obstruction, and LPA taking temperature measurments of the water throughout the facility. LPA reviewed and obtained copies of medication administration records, samples of employee covid-19 daily symptom attestation forms, diet matrix and staff schedule for November 17th, 2021.
It is alleged that the kitchen sink is clogged and has been clogged for more than one month. LPA observed while running the water the kitchen sink that the water was backing up and that debris was present in the sink.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amy Goldenberg
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2021
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 6
Control Number 18-AS-20211116083945
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: FIRST STEP CORONA
FACILITY NUMBER: 336426108
VISIT DATE: 12/06/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Seven (7) of seven (7) staff interviewed report that the sink backs up and/or the garbage disposal is not working causing the sink to back up. LPA has confirmed that the facility kitchen sink is not maintained in working order.

It is alleged that the water temperature in the kitchen and bathrooms are too hot. LPA measured the water temperature in two resident restrooms. The resident restrooms located at the back of the building by the drop off entrance, men's and women's sinks measured under regulation temperature at 99 degrees F. Kitchen sink water measured 125 degrees F, which is over regulatory requirement of 105 to 120 degrees F. Client restrooms at the front of the building both measured 112 degrees F and meets the requirement. LPA has confirmed that the facility water temperature is not maintained within required temperature range.

We have substantiated the complaint allegations as valid and that a violation has occurred based on the preponderance of available evidence. A copy of this report along with appeal rights are being reviewed with, and furnished to the facility representative. Please see LIC 9099D.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amy Goldenberg
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 18-AS-20211116083945
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: FIRST STEP CORONA
FACILITY NUMBER: 336426108
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/06/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/07/2021
Section Cited
CCR
82087(a)
1
2
3
4
5
6
7
82087 Buildings and Grounds (a) The program site shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.The facility failed to meet
1
2
3
4
5
6
7
Facility Director reports that a work order is in and they are waiting for maintenence to come and repair the sink. Maintenence request to be provided to LPA.
8
9
10
11
12
13
14
this requirement as evidenced by seven (7) of seven (7) staff report that the sink backs up and/or the garbage disposal is not working causing the sink to back up and LPA observation.
8
9
10
11
12
13
14
Type A
12/07/2021
Section Cited
CCR
876987
1
2
3
4
5
6
7
(1) Hot water temperature ...delivered to plumbing fixtures to attain a hot water temperature of not less than 105 degrees F and not more than 120 degrees F. The facility failed to meet this requirement as evidenced by
1
2
3
4
5
6
7
Facility Director reports that a work order is in and they are waiting for maintenence to come and adjust the water. Maintenence request to be provided to LPA.
8
9
10
11
12
13
14
Water temperature in the kitchen measuring 125 degrees F and measuring 99 degrees F in the rear client restroom sinks.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amy Goldenberg
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2021
LIC9099 (FAS) - (06/04)
Page: 6 of 6