336426511-2-9-2023-56-AS-EMAN-CQ6VR2-20230322163912

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336426511
Report Date: 02/09/2023
Date Signed: 02/09/2023 10:42:38 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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
02/06/2023 and conducted by Evaluator Ryan Gardner

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20230206152838

FACILITY NAME:	AVISTA SENIOR LIVING MAGNOLIA		FACILITY NUMBER:	336426511
ADMINISTRATOR:	BLASIA LEE-LOLE		FACILITY TYPE:	740
ADDRESS:	737 MAGNOLIA AVE		TELEPHONE:	(951) 737-1600
CITY:	CORONA	STATE: CA	ZIP CODE:	92879
CAPACITY:	180	CENSUS: 119	DATE:	02/09/2023
		UNANNOUNCED	TIME BEGAN:	09:12 AM
MET WITH:	Blasia Lee-Lole- Administrator		TIME COMPLETED:	10:55 AM

ALLEGATION(S):

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Staff do not properly maintain the facility.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ryan Gardner arrived at the facility unannounced to initiate and deliver findings for the above complaint allegation. LPA met with Administrator Blasia Lee-Lole and explained the reason for the visit.

During today’s visit, LPA toured the facility, conducted interviews with staff and residents, and reviewed, and was provided facility documents.

For allegation, Staff do not properly maintain the facility:

During document review, LPA discovered that the facility has three (3) maintenance staff on duty between the hours of 8:30 am and 5:00pm. The facility averages eight (8) housekeeping staff on duty between the hours of 7:30 am and 5:00 PM.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-8222
LICENSING EVALUATOR NAME: Ryan Gardner	TELEPHONE: (951) 836-3180
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023

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 56-AS-20230206152838

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: AVISTA SENIOR LIVING MAGNOLIA	FACILITY NUMBER: 336426511
	VISIT DATE: 02/09/2023

NARRATIVE

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During interviews conducted with staff, LPA discovered that the hallways are cleaned daily, and the residents’ bedrooms are cleaned once a week. If a resident has a needed for more than one cleaning a week, the housekeeping staff will complete extra cleanings to ensure the resident has a clean-living space. If a resident soils a chair, mattress or a furniture item, the maintenance staff will remove the soiled liquid, and clean the furniture with a shampooer to ensure the furniture is clean and free from odor. When there are no maintenance staff or housekeeping staff on duty, the caregivers will step in to help clean the facility.

During interviews with residents, LPA discovered that there were no concerns with the smell of the facility. The residents stated they did not smell any foul odors.

During LPA tour of the facility, LPA did not smell any foul odors. The facility was clean and had a fresh smell throughout.

Based on the evidence gathered during today’s investigation, the allegation listed above is deemed UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means 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.

During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.

An exit interview was conducted, and this report (LIC9099) was discussed and provided Administrator Blasia Lee-Lole, along with a copy of the appeal rights.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-8222
LICENSING EVALUATOR NAME: Ryan Gardner	TELEPHONE: (951) 836-3180
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023

LIC9099 (FAS) - (06/04)

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