336426771-7-27-2023-18-AS-EMAN-CX5SB3-20231031134316

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336426771
Report Date: 07/27/2023
Date Signed: 07/27/2023 02:41:03 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
11/30/2021 and conducted by Evaluator Paola Guerrero

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20211130104938

FACILITY NAME:	ACCURO HOMES		FACILITY NUMBER:	336426771
ADMINISTRATOR:	LESLEY VANNOY		FACILITY TYPE:	740
ADDRESS:	6764 BLACK FOREST DRIVE		TELEPHONE:	(951) 479-5260
CITY:	EASTVALE	STATE: CA	ZIP CODE:	92880
CAPACITY:	6	CENSUS: 6	DATE:	07/27/2023
		UNANNOUNCED	TIME BEGAN:	12:13 PM
MET WITH:	April Lopez		TIME COMPLETED:	02:50 PM

ALLEGATION(S):

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Facility retaliated for resident filing complaint.
Staff is not allowing resident to meet with their Resident Representative.
Staff is not allowing resident to communicate with their Resident Representative.
Resident's sleeping needs are not being met.
Resident's incontinence needs not being met.
Facility is unsanitary.
Facility is dirty.
Staff did not ensure that resident was changed into sleepwear at nightime
Resident is being forced to eat.

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 allegation listed above. The investigation consists of direct observations, records review, and interviews regarding the above allegation.

First Allegation: Facility retaliated for resident filing complaint.

Regarding the first allegation, facility retaliated for resident filing complaint. LPA conducted an interview with Facility Administrator who stated facility/nor facility staff has never retaliated towards any resident, staff, or family members who file complaints against facility. LPA conducted interviews with Resident #2 (R2) Resident #3 (R3) Resident #4 (R4), and Resident #5 (R5) who all stated that they feel comfortable/and safe at the facility and have no fear of retaliation from the facility when needing to file a complaint or voice out any concerns. Resident #2-5 all stated that they feel safe.

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: 07/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023

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 5

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
11/30/2021 and conducted by Evaluator Paola Guerrero

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20211130104938

FACILITY NAME:	ACCURO HOMES		FACILITY NUMBER:	336426771
ADMINISTRATOR:	LESLEY VANNOY		FACILITY TYPE:	740
ADDRESS:	6764 BLACK FOREST DRIVE		TELEPHONE:	(951) 479-5260
CITY:	EASTVALE	STATE: CA	ZIP CODE:	92880
CAPACITY:	6	CENSUS: 6	DATE:	07/27/2023
		UNANNOUNCED	TIME BEGAN:	12:13 PM
MET WITH:	April Lopez		TIME COMPLETED:	02:50 PM

ALLEGATION(S):

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Staff are not following resident's care plan.
Resident's hygiene needs not being met.
Facility is not adhering to Admissions Agreement.

INVESTIGATION FINDINGS:

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Sixth Allegation: Facility is unsanitary.
Regarding sixth allegation, Facility is unsanitary. LPA inspected facility kitchen along with resident’s bedrooms; LPA observed furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. Overall, the facility is clean, food preparation area was clean and sanitized, appliances were in good repair, and operating in safe conditions for clients in care.

Seventh Allegation: Facility is dirty.

Regarding seventh allegation, Facility is dirty. LPA inspected facility along with resident’s bedrooms; LPA observed furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. Overall, the facility is clean, appliances were in good repair, and operating in safe conditions for clients in care.

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: 07/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023

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

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 18-AS-20211130104938

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: 07/27/2023

NARRATIVE

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Eighth Allegation: Staff did not ensure that resident was changed into sleepwear at nigh time.
Regarding eighth allegation, staff did not ensure that resident was changed into sleepwear at nigh time. LPA conducted a file review and observed daily notes pertaining to Resident #1 (R1) daily needs. Based on notes Residents #1 needs were met. LPA interviewed Residents #2-5 and asked residents if their daily needs such sleepwear/pajama change gets completed before nighttime Residents #2-5 stated that facility caregivers are on top of that every night and ensures that their diapers are changed along with their clothes. Residents #2-5 stated that they have not witnessed residents not being changed into sleepwear at nighttime.

Ninth Allegation: Resident is being forced to eat.
Regarding ninth allegation, resident is being forced to eat. LPA conducted interviews with Resident #2 (R2), Resident #3 (R3), Resident #4 (R4), and Resident #5 (R5), who all stated that they have not witnessed or experienced staff forcing resident[s] to eat. Resident #2-5 stated when they are not hungry staff will prepare something on a later time for them to eat.

Tenth Allegation: Staff are not following resident's care plan.
Regarding tenth allegation, Staff are not following resident's care plan. LPA reviewed Resident #1 care plan along with daily care notes which indicate that Resident #1 care plan was followed. LPA LPA interviewed Residents #2, Resident #3, Resident #4, and Resident #5 and asked if facility follows their care plan needs, Residents #2, Resident #3, Resident #4, and Resident #5 all stated that facility is good with following their care plan along with making any changes based on their physicians’ orders.

Eleventh Allegation: Resident's hygiene needs not being met.
Regarding eleventh allegation, Resident's hygiene needs not being met. LPA interviewed Residents #2, Resident #3, Resident #4, and Resident #5 and asked if their hygiene needs are being met Resident #2, Resident #3, Resident #4, and Resident #5 stated that their hygiene needs are always met. Residents #2-5 all stated that they have no concerns and that their daily needs are always met by the facility.

Twelfth Allegation: Facility is not adhering to Admissions Agreement.
Regarding twelfth allegation, Facility is not adhering to Admissions Agreement. LPA 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.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Paola Guerrero	TELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 18-AS-20211130104938

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: 07/27/2023

NARRATIVE

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Based on the evidence obtained during the course of the investigation, LPA has determined that the above allegations are UNSUBSTANTIATED.

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 Facility Administrator April Lopez at the end of the visit.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Paola Guerrero	TELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023

LIC9099 (FAS) - (06/04)

Page: 5 of 5

Control Number 18-AS-20211130104938

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: 07/27/2023

NARRATIVE

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Second Allegation: Staff is not allowing resident to meet with their Resident Representative.

Regarding the second allegation, Staff is not allowing resident to meet with their Resident Representative. LPA Guerrero spoke to facility Administrator and asked if the facility has ever denied residents their visitation rights. Administrator stated they are aware of every resident’s personal right and facility has not ever deny any resident their visitation rights. Administrator stated for any family who is loud or disruptive towards other clients in care facility will then offer other alternatives such as: the back patio for visitation area. LPA interviewed Resident #2-5 who all stated that they have not witnessed or experienced visitation rights to be violated.

Third Allegation: Staff is not allowing resident to communicate with their Resident Representative.

Regarding third allegation, Staff is not allowing resident to communicate with their Resident Representative.
LPA interviewed Resident #2-5 who all stated that they have not witnessed or experienced facility staff prevent them (R#2-5), from utilizing their phones to make calls or take calls from family members, or health representatives. Resident #2-5 stated that facility staff are good with communicating to family members any concern’s pertaining to residents.

Fourth Allegation: Resident's sleeping needs are not being met.

Regarding fourth allegation, resident's sleeping needs are not being met. LPA conducted a file review and observed daily notes pertaining to Residents #1 (R1) daily care and needs. Based on notes LPA observed Resident #1 (R1) receiving calls between (9:45pm,11:00pm,10:41pm) from family member. LPA interviewed Residents #2-5 regarding their sleeping needs not being met who all stated that they have no issues or concerns regarding their sleepings needs. Resident #2-5 stated facility ensures that their rooms are comfortable and set at a comfortable temperature for them to sleep well.

Fifth Allegation: Resident's incontinence needs not being met.

Regarding fifth allegation, resident's incontinence needs not being met. LPA conducted a file review and observed daily notes pertaining to Resident #1 (R1) daily care and needs. Based on notes LPA observed that showers, pull-up change, and daily hygiene needs were met. Administrator stated that diaper change is done three times a day and depending on if resident soils. Administrator also stated that pull-ups are utilized on residents who are capable on retaining their own bladder. LPA interviewed Residents #2-5 and asked if their incontinence needs are being met Resident #2, and Resident #3 stated that their diapers are changed daily depending on their lack of control over their urination/feces staff will then change frequently.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Paola Guerrero	TELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 5