336426708-1-23-2023-18-AS-DMUN-CNGU5C-20230127141629

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336426708
Report Date: 01/23/2023
Date Signed: 01/23/2023 05:19:00 PM

Unfounded

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
09/27/2022 and conducted by Evaluator Stephanie Torres

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20220927205726

FACILITY NAME:	ABOUNDING LOVE HOME CARE		FACILITY NUMBER:	336426708
ADMINISTRATOR:	DELA CRUZ, DENNIS		FACILITY TYPE:	740
ADDRESS:	13213 NAPA VALLEY COURT		TELEPHONE:	(951) 961-1303
CITY:	MORENO VALLEY	STATE: CA	ZIP CODE:	92555
CAPACITY:	6	CENSUS: 5	DATE:	01/23/2023
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Cheryl De La Cruz, Administrator		TIME COMPLETED:	05:30 PM

ALLEGATION(S):

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Resident developed a UTI while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Stephanie Torres, conducted an unannounced visit to the facility to deliver the findings of the investigation into the above allegation. The LPA met with Administrator, Cheryl De La Cruz, and informed her of the purpose of her visit.
The LPA started the investigation on October 03, 2022; staff/resident interviews were conducted, records reviewed, copies obtained, and a tour conducted. It was alleged Resident One (R1) developed a urinary tract infection (UTI) due to inadequate care. Interviews revealed R1 was not hospitalized while residing at the facility and did not develop any other conditions other than a rash on the genitals. Interviews reported, the facility did not provide sufficient care regarding incontinence services. A record review was conducted; no medical assessment (Physician's Report) was observed on file. Documentation was found on file detailing logs for incontinence assistance provided by staff. Staff interviews revealed R1 did not have a rash on their genitals. Therefore, based on interviews, this allegation is deemed UNFOUNDED. A finding that the complaint is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. This report was reviewed with De La Cruz and a copy was provided.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Deborah Mullen	TELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Stephanie Torres	TELEPHONE: (951) 204-5924
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023

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 3

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
09/27/2022 and conducted by Evaluator Stephanie Torres

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20220927205726

FACILITY NAME:	ABOUNDING LOVE HOME CARE		FACILITY NUMBER:	336426708
ADMINISTRATOR:	DELA CRUZ, DENNIS		FACILITY TYPE:	740
ADDRESS:	13213 NAPA VALLEY COURT		TELEPHONE:	(951) 961-1303
CITY:	MORENO VALLEY	STATE: CA	ZIP CODE:	92555
CAPACITY:	6	CENSUS: 5	DATE:	01/23/2023
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Cheryl De La Cruz, Administrator		TIME COMPLETED:	05:30 PM

ALLEGATION(S):

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Staff do not follow proper hand washing procedures.
Staff did not safeguard resident's personal items.
Resident's room is malodorous.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Stephanie Torres, conducted an unannounced visit to the facility to deliver the findings of the investigation into the above allegations. The LPA met with Administrator, Cheryl De La Cruz, and informed her of the purpose of her visit.

A report was received alleging the facility staff do not wash their hands prior to preparing meals. Staff/resident interviews were conducted. Staff denied the allegation. Residents reported having no knowledge of whether staff do or do not wash their hands prior to preparing meals. A records review was conducted; the review revealed documentation to be on file relating to food service and universal precautions. Due to insufficient information, this allegation is deemed UNSUBSTANTIATED at this time.

It was alleged an unknown staff member stole $40 from Resident Two's (R2's) bedroom. Interviews could provide no information pertaining to the allegation. Therefore, this allegation is deemed UNSUBSTANTIATED at this time.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Deborah Mullen	TELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Stephanie Torres	TELEPHONE: (951) 204-5924
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 18-AS-20220927205726

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: ABOUNDING LOVE HOME CARE	FACILITY NUMBER: 336426708
	VISIT DATE: 01/23/2023

NARRATIVE

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Finally, it was reported one resident bedroom smells due to one resident not managing their hygiene. On October 03, 2022, the LPA conducted a tour of the facility and observed no odors. One interview revealed their bedroom does smell when their restroom is used, and residents do not close the door. Additional interviews could not provide any information regarding the allegation. Therefore, this allegation is deemed UNSUBSTANTIATED at this time.

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 violations occurred.

This report was reviewed with De La Cruz and a copy was provided.

SUPERVISOR'S NAME: Deborah Mullen	TELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Stephanie Torres	TELEPHONE: (951) 204-5924
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023

LIC9099 (FAS) - (06/04)

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