336426759-1-23-2024-18-AS-RSTS-CZYUNU-20240130144431

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336426759
Report Date: 01/23/2024
Date Signed: 01/23/2024 09:43:31 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 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
12/19/2023 and conducted by Evaluator Sara Martinez

COMPLAINT CONTROL NUMBER: 18-AS-20231219181442

FACILITY NAME:	CITRUS GARDENS		FACILITY NUMBER:	336426759
ADMINISTRATOR:	TRACY LANGENDOEN		FACILITY TYPE:	740
ADDRESS:	25911 STANFORD ST		TELEPHONE:	(951) 925-7107
CITY:	HEMET	STATE: CA	ZIP CODE:	92544
CAPACITY:	55	CENSUS: 53	DATE:	01/23/2024
		UNANNOUNCED	TIME BEGAN:	09:09 AM
MET WITH:	Ashlee Theus - Buisness Office Manager		TIME COMPLETED:	09:53 AM

ALLEGATION(S):

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Facility staff are not ensuring that resident has access to a phone while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sara Martinez conducted an unannounced visit to conclude and deliver findings to an investigation regarding the allegation listed above. LPA was granted entry and met with Buisness Office Manager Ashlee Theus. The allegation was investigated and consisted of observation, interviews, and record review.

Regarding the allegation “Facility staff are not ensuring that resident has access to a phone while in care”, it was alleged a telephone is not accessible to Resident One (R1) who is bedridden. LPA conducted an interview with Business Office Manager Ashlee Theus regarding residents’ accessibility to a telephone at the facility. Theus stated there is a telephone accessible to every resident in each villa at the facility. Residents who do not have a cellphone with an ambulatory status of bedridden can request to use the administrative staffs’ cellphone while on duty to make outgoing calls or receive calls.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rikesha Stamps	TELEPHONE: (951) 212-0616
LICENSING EVALUATOR NAME: Sara Martinez	TELEPHONE: (951) 248-0314
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024

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-20231219181442

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: CITRUS GARDENS	FACILITY NUMBER: 336426759
	VISIT DATE: 01/23/2024

NARRATIVE

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Reporting Party (RP) stated they tried multiple times to contact R1 via telephone and whenever RP called the facility requesting to speak to R1, a staff member would inform RP that Theus was not available and to call back later in the day when Theus is at the facility so they could speak to R1.

Interview with R1 revealed if they requested a telephone to make or receive a phone call, staff would make a telephone accessible for R1. During LPA’s initial visit on 12/27/23, LPA observed a working telephone accessible to residents in each villa and a telephone available for use in the front office.

LPA called the facility on 01/03/2024 and LPA spoke to Executive Director Diana Ramirez. LPA requested to speak to R1 and Ramirez informed LPA that R1 is bedridden and LPA would need to call Ramirez’s cellphone to communicate with R1. Ramirez gave LPA their cellphone number so R1 could have access to a telephone while in care. Therefore, based on interviews, record review, and observations, the allegation “Facility staff are not ensuring that resident has access to a phone while in care” has been deemed UNSUBSTANTIATED at this time.

A finding that the allegation(s) are 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 violation(s) occurred.

An exit interview was conducted where a copy of this report was discussed and provided to Theus, along with a copy of LIC811-Confidential Names.

SUPERVISOR'S NAME: Rikesha Stamps	TELEPHONE: (951) 212-0616
LICENSING EVALUATOR NAME: Sara Martinez	TELEPHONE: (951) 248-0314
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024

LIC9099 (FAS) - (06/04)

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