336426470-12-8-2021-18-AS-JESL-CA7SAD-20211230124210

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336426470
Report Date: 12/08/2021
Date Signed: 12/08/2021 12:19:40 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
01/08/2020 and conducted by Evaluator David Cuevas

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20200108140948

FACILITY NAME:	ATTENTIVE MANOR		FACILITY NUMBER:	336426470
ADMINISTRATOR:	MATTHEW SIEGEL		FACILITY TYPE:	740
ADDRESS:	66-338 FOURTH ST.		TELEPHONE:	(760) 251-4330
CITY:	DESERT HOT SPRINGS	STATE: CA	ZIP CODE:	92240
CAPACITY:	6	CENSUS: 0	DATE:	12/08/2021
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Licensee, Matthew Siegel		TIME COMPLETED:	12:20 PM

ALLEGATION(S):

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Staff caused injuries to residents while in care
Staff spoke inappropriately towards residents while in care

INVESTIGATION FINDINGS:

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On 12/8/21 Licensing Program Analyst (LPA) David Cuevas conducted an unannounced visit to the above facility to follow up with complaint control #18-AS-20200108140948. LPA identified self and was granted permission to enter facility. LPA met with Administrator, Matthew Siegel who was informed of the purpose of visit.

During the investigation LPA Cuevas conducted: facility file review, resident record review, interviews with staff, residents, and witness, conducted observations, and review of pertinent documents.

Allegation #1: Staff caused injuries to residents while in care.
Based on interviews and statements provided by staff, residents, and witnesses there was not enough supporting evidence to identify victims or physical abuse to have occurred at the facility. An onsite visit was done on January 17, 2020, that revealed suspected victim identified does not reside at the facility and is not a resident. Furthermore, initial information provided with allegations was limited as it did not specify which resident(s) were being physically abused and failed to identify witnesses who could corroborate allegations.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: David Cuevas	TELEPHONE: (951) 295-3927
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2021

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-20200108140948

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: ATTENTIVE MANOR	FACILITY NUMBER: 336426470
	VISIT DATE: 12/08/2021

NARRATIVE

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As such this department deems the allegation of, Staff caused injuries to residents while in care to be UNSUBSTANTIATED; meaning that although the allegation may have happened or is valid, there is not enough preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED at this time.

Allegation #2: Staff spoke inappropriately towards residents while in care

Based on interviews and statements provided by staff, residents, and witnesses, there is not enough preponderance of evidence produced that would identify staff speaking inappropriately to residents in care. A site visit was done on January 17, 2020, during this investigation residents and family members reported to be content with placement and to have no knowledge of staff conducting themselves in such a manner. As such this department deems the allegation of, Staff spoke inappropriately towards residents while in care to be UNSUBSTANTIATED; meaning that although the allegation may have happened or is valid, there is not enough preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED at this time.

An exit interview was conducted with Licensee/ Administrator, Matthew Siegel were a copy of this report was reviewed and provided.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: David Cuevas	TELEPHONE: (951) 295-3927
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021

LIC9099 (FAS) - (06/04)

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