336426771-6-20-2023-18-AS-EMAN-CT6T7B-20230626142828

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336426771
Report Date: 06/20/2023
Date Signed: 06/20/2023 02:30:38 PM

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
02/11/2022 and conducted by Evaluator Paola Guerrero

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20220211162541

FACILITY NAME:	ACCURO HOMES		FACILITY NUMBER:	336426771
ADMINISTRATOR:	LESLEY VANNOY		FACILITY TYPE:	740
ADDRESS:	6764 BLACK FOREST DRIVE		TELEPHONE:	(951) 415-0647
CITY:	EASTVALE	STATE: CA	ZIP CODE:	92880
CAPACITY:	6	CENSUS: 6	DATE:	06/20/2023
		UNANNOUNCED	TIME BEGAN:	11:20 AM
MET WITH:	April Lopez		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff not providing a comfortable environment for resident.
Resident sustained unexplained injury while in care.
Facility bathroom is in disrepair.
Staff failed to abide by admission agreement.
Staff does not award resident with phone calls.
Staff does allow resident to have meals in resident's room.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to initiate and deliver the findings for the above allegation. LPA met with Facility Administrator April Lopez who was informed of the purpose of my visit and the allegations listed above. The investigation consists of direct observations, records review, and interviews regarding the above allegations.

First Allegation: Staff not providing a comfortable environment for resident.

Regarding the first allegation, Staff not providing a comfortable environment for resident. LPA Guerrero conducted a facility walkthrough and observed the facility to be clean, in good repair, and operating in safe conditions. LPA conducted in-person interviews with Resident #2, Resident #3, Resident #4, and Resident #5, who all stated that they feel comfortable, and safe at the facility, Resident#1 and Resident #3 stated that they all get along with each other and are all friends with one another.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Paola Guerrero	TELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

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 18-AS-20220211162541

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: ACCURO HOMES	FACILITY NUMBER: 336426771
	VISIT DATE: 06/20/2023

NARRATIVE

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Second Allegation: Resident sustained unexplained injury while in care.

Regarding the second allegation, Resident sustained an unexplained injury while in care. LPA Guerrero conducted a file review and observed that on 8/29/21 Resident #1 was seen at Riverside Medical Center due to a fall that occurred at the facility. Administrator stated that Resident #1 had fallen from the bed and obtain a contusion on left leg. Administrator stated that a Special Incident Report (SIR), was faxed to CCL office, and resident’s responsible party was notified of the incident.

Third Allegation: Facility bathroom is in disrepair.

Regarding the third allegation, Facility bathroom is in disrepair. LPA Guerrero conducted a bathroom inspection and observed appliances were operating appropriately. LPA also measured and observed the water temperatures in three (3) bathrooms to be at 105.4 degrees F.

Fourth Allegation: Staff failed to abide by admission agreement.

Regarding the fourth allegation, Staff failed to abide by admission agreement. LPA Guerrero reviewed admissions agreement (Facility Policies) which states that smoking “IN” the facility is strictly forbidden. LPA conducted in-person interviews with Resident #2, Resident #3, Resident #4, and Resident #5 who all stated that they have not witness any resident smoking inside the facility. Resident #3, and Resident #4, stated that facility has a designated smoking area in the backyard for residents to smoke.

Fifth Allegation: Staff does not award resident with phone calls.

Regarding the fifth allegation, Staff does not award resident with phone calls. LPA Guerrero conducted interviews with Staff #1, Staff #2, and Staff #3, who deny not allowing/or denying residents from making phone calls. LPA conducted an in-person interview with Resident #2, Resident #3, Resident #4, and Resident #5, who all stated that they have not witnessed or experienced staff denying or preventing residents from making phone calls.

Sixth Allegation: Staff does not allow resident to have meals in resident's room.

Regarding the sixth allegation, Staff does not allow resident to have meals in resident’s room. LPA Guerrero conducted interviews with Staff #1-3 who deny not allowing residents to have their meals in their room. Staff #1 stated that it is the resident’s right if they decide that they want to eat their meal in their room. LPA conducted interviews with Resident #2, Resident #3, Resident #4, and Resident #5 who all stated that they have not witness staff denying residents from eating their meals in their room. Due to a lack of information, the above allegations are deemed UNSUBSTANTIATED at this time.

Unsubstantiated; meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted where this report was discussed and provided to Facility Administrator April Lopez.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Paola Guerrero	TELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

LIC9099 (FAS) - (06/04)

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