336426759-7-20-2021-18-AS-EMAN-C894J3-20211028190803

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336426759
Report Date: 07/20/2021
Date Signed: 07/20/2021 02:35:57 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
07/20/2021 and conducted by Evaluator Stephanie Williams

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20210720092423

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: 39	DATE:	07/20/2021
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Diana Ramirez		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff person yells at the residents.
Residents are not being fed regularly.
Staff are not wearing masks.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Stephanie Williams conducted an unannounced visit to the facility in order to deliver findings for the above allegations. LPA met with Business Office Manager, Diana Ramirez, and explained the purpose of today's visit. The investigation consisted of records review, direct observations, and interviews with staff and residents.

In regards to allegation #1, LPA interviewed Resident #1 (R1), Resident #2 (R2), and Resident #3 (R3) who all denied that staff members yell or speak inappropriately to residents. Both R1 and R2 stated that staff members treat them well. LPA interviewed Staff #1 (S1), Staff #2 (S2), and Staff #3 (S3) who all denied witnessing staff members yelling or speaking inappropriately to residents. S1 stated that Staff #4 (S4) is a "good employee" who just recently received a promotion due to S4's good rapport with residents.

In regards to allegation #2, LPA interviewed R1, R2, and R3 who all stated that they have three meals a day and snacks in between those meals. R1 stated that "the food is good" and that they have not gone without

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-0337
LICENSING EVALUATOR NAME: Stephanie Williams	TELEPHONE: (951) 248-0317
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021

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-20210720092423

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: CITRUS GARDENS	FACILITY NUMBER: 336426759
	VISIT DATE: 07/20/2021

NARRATIVE

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a meal at the facility. R2 stated that they are "fed well." LPA interviewed S1, S2, and S3 who stated that there are no issues with sufficient staffing in the kitchen. S1, S2, and S3 stated that all residents are fed three times a day and snacks in between those meals. Both S1 and S2 stated that some residents have a tendency to refuse to eat; however, they are provided with meal substitutes. S1, S2, and, S3 deny that residents are not being fed regularly.

In regards to allegation #3, S1 and S2 stated that it is facility protocol that all staff members wear face coverings while at the facility. S1, S2, and S3 all stated that all staff members comply with facility protocol in regards to face coverings. LPA observed that all staff members were utilizing face coverings at the time of visit.

Based on evidence obtained during the investigation, LPA has determined that the above allegations are UNSUBSTANTIATED; meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted where this report (LIC 9099) was discussed and a copy was provided to Ramirez.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-0337
LICENSING EVALUATOR NAME: Stephanie Williams	TELEPHONE: (951) 248-0317
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021

LIC9099 (FAS) - (06/04)

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