336427235-2-15-2023-18-AS-NBRN-CPFQJB-20230227111229

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336427235
Report Date: 02/15/2023
Date Signed: 02/15/2023 11:46:20 AM

Unsubstantiated

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
, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/11/2021 and conducted by Evaluator Amy Goldenberg

COMPLAINT CONTROL NUMBER: 18-AS-20210511120106

FACILITY NAME:	CORONA RESIDENTIAL CARE CENTER LLC		FACILITY NUMBER:	336427235
ADMINISTRATOR:	AHARON STRIKS		FACILITY TYPE:	740
ADDRESS:	1400 CIRCLE CITY DR		TELEPHONE:	(951) 735-0252
CITY:	CORONA	STATE: CA	ZIP CODE:	92879
CAPACITY:	125	CENSUS: 36	DATE:	02/15/2023
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Mary Gonzales, Administrator		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff handled resident in a rough manner

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

This unannounced visit by Amy Goldenberg, Licensing Program Analyst (LPA), is being conducted to conclude this agency’s investigation of the allegation noted above. Investigation consisted of resident and staff interviews. It is alleged that S1 scratched the bottom of C1 during personal care. Investigation revealed the following: Five (5) out of (5) residents interviewed agree that they have never been treated roughly during personal care. Four (4) of four (4) staff interviewed deny handling residents roughly during personal care or have knowledge of staff handling residents roughly during personal care. At this time the evidence does not support or refute the allegation. We have found the complaint allegations are unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. A copy of this report is being reviewed with and furnished to the facility representative.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Nedra Brown	TELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Amy Goldenberg	TELEPHONE: (951) 201-3990
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023

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 2