336426511-7-8-2020-18-AS-EMAN-BRY274-20200728170806

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336426511
Report Date: 07/08/2020
Date Signed: 07/08/2020 10:12:57 AM

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
04/15/2020 and conducted by Evaluator Robbie Johnson

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20200415113243

FACILITY NAME:	BROOKDALE MAGNOLIA		FACILITY NUMBER:	336426511
ADMINISTRATOR:	SARAH DEVORE		FACILITY TYPE:	740
ADDRESS:	737 MAGNOLIA AVE		TELEPHONE:	(951) 737-1600
CITY:	CORONA	STATE: CA	ZIP CODE:	92879
CAPACITY:	180	CENSUS: 149	DATE:	07/08/2020
		UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Exectuve DIrector Mary Mcclure		TIME COMPLETED:	10:15 AM

ALLEGATION(S):

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Facility has pests

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Robbie Johnson contacted the facility to deliver findings regarding the above allegation via telephone due to COVID-19. LPA identified herself and discussed the purpose of the call and the elements of the above allegation with Executive Director Mary Mcclure.

During the course of the investigation interviews were conducted with four (4) staff members and four (4) residents. It is alleged that the facility has rats. Interviews with the maintenance director revealed that an inspection of the facility was completed on two occassions and no evidence of rats or any other type of vermin was observed. Interviews with several residents revealed that no rats have been observed in the facility. Based on interviews with several staff and residents, LPA could not corroborate that rats are in the building. The allegation is unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged abuse occurred. A copy of this report was reviewed with and provided to the Executive director via email.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Robbie Johnson	TELEPHONE: (951) 248-0304
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2020

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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