336427235-5-15-2023-56-AS-EMAN-CT6SG9-20230626135135

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336427235
Report Date: 05/15/2023
Date Signed: 05/15/2023 11:56:14 AM

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
05/09/2023 and conducted by Evaluator Ryan Gardner

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20230509150654

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: 90	DATE:	05/15/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Maria "Mary" Gonzalez- Administrator Assistant		TIME COMPLETED:	12:05 PM

ALLEGATION(S):

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Staff failed to supervise residents in care.
Staff did not safeguard resident's personal property.
Staff did not treat resident with dignity or respect.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ryan Gardner conducted an unannounced visit to the facility for the purpose of initiating an investigation and delivering findings for the above complaint allegations. LPA met Administrator Assistant Maria "Mary" Gonzalez and explained the reason for the visit.

During today’s visit, LPA reviewed, and requested facility documents, interviewed staff, and interviewed residents.

For allegation, Staff failed to supervise residents in care:

It was alleged that there was an argument between two (2) residents over an electric wheelchair, plants, and a speaker.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-8222
LICENSING EVALUATOR NAME: Ryan Gardner	TELEPHONE: (951) 836-3180
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023

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 4

Control Number 56-AS-20230509150654

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: CORONA RESIDENTIAL CARE CENTER LLC	FACILITY NUMBER: 336427235
	VISIT DATE: 05/15/2023

NARRATIVE

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During interviews with the two residents, LPA discovered that Resident R1 borrowed a wheelchair from Resident R2. The wheelchair somehow became broken, but neither resident knows how it broke or saw how it broke. R2 at one point asked for the wheelchair back, but then later stated they did not want the wheelchair back and wanted to let the argument go. It was also alleged that the residents both stole a speaker from each other. Both residents denied stealing a speaker. It was also alleged that both residents stated they were going to hurt each other, but both parties denied that a threat was made to each other. The residents were both were offered to report their concerns to the police, but they both choose not to speak to the police about the issues. The residents were both offered by staff to be moved to a different bedroom in the facility to be separated. Both residents chose not to move. Both of the residents also alleged that each other were messing with and or breaking their plants on their porch. Both residents denied touching and or breaking each other’s plants. LPA was informed by both residents that they used to be friends and now are choosing not to be involved with one another.

During interviews with the staff, LPA discovered that the two residents were friends and had been arguing back and forth. The residents both made allegations against each other of hurting each other, stealing a speaker, breaking plants, and breaking a wheelchair. Once staff was made aware of the issues, staff called the local police department to report the concerns. Both residents refused to talk to the police and wanted to drop the issues. The residents were both offered to be moved to different bedrooms in the facility to separate the residents. The residents both declined to move and chose to stay in their assigned bedrooms. The facility staff has been notified to keep closer a watch on the two (2) residents and to inform management if they notice any concerns regarding the two (2) residents.

For allegation, Staff did not safeguard resident's personal property:

It was alleged that a staff went into a resident’s room and removed a personal item.

During interview with the R1, LPA was informed that R1 alleged that an unknown staff came into their bedroom while they were gone and removed a personal item from the bedroom. R1 does not know when the personal item was removed from the bedroom. R1 stated they assume a staff took it when they were out of the facility.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-8222
LICENSING EVALUATOR NAME: Ryan Gardner	TELEPHONE: (951) 836-3180
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 56-AS-20230509150654

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: CORONA RESIDENTIAL CARE CENTER LLC	FACILITY NUMBER: 336427235
	VISIT DATE: 05/15/2023

NARRATIVE

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During interviews with staff, LPA was informed that Staff S1 was in R1’s bedroom with R1 present. S1 was in the bedroom to pass R1’s morning medication. S1 saw a personal item on the floor and asked R1 to explain what it was. R1 did answer the question. R1 picked up the item and stated it did not belong to R1. S1 did not remove the item from R1’s bedroom. S1 reported the concerning item to management. A letter was given to R1 by S2 on 5/4/23 for having a questionable item in their bedroom. The letter included a reminder of the facilities house rules and the regulation pertaining to the house rule.

During document review, LPA was shown the letter that was given to R1. LPA explained to S2 that the facility does not have proof that the item in the R1’s bedroom is what S1 assumed it was. LPA explained that a letter can not be issued off an assumption of a resident’s personal item.

For allegation, Staff did not treat resident with dignity or respect:

It was alleged that a staff member refuses to speak to a resident.

During interview with R1, R1 stated that communication is done only through letters that are slid under the bedroom door. R1 stated that S2 will not talk to them in person regarding issues and only wants to document on letters.

During interview with S2, S2 stated that when letters are given to residents the letter is hand delivered to ensure the resident received the letter and to ensure the resident understands the letter. S2 stated that when letters are delivered to residents two (2) staff are present. S1 stated that the residents are treated with respect, fairness, and they are not ignored or communicated with only through letters.

During interview with S1, S1 stated that the residents are treated with respect and are spoken to in person. S1 stated that the residents are not ignored and are given letters or notices in person.

Based on the evidence discovered during the investigation, the three (3) allegations listed above are deemed UNSUBSTANTIATED.

A finding that the complaints are UNSUBSTANTIATED means 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.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-8222
LICENSING EVALUATOR NAME: Ryan Gardner	TELEPHONE: (951) 836-3180
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 56-AS-20230509150654

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: CORONA RESIDENTIAL CARE CENTER LLC	FACILITY NUMBER: 336427235
	VISIT DATE: 05/15/2023

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32	During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report was discussed and provided to Administrator Assistant Maria "Mary" Gonzalez, along with a copy of the appeal rights.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-8222
LICENSING EVALUATOR NAME: Ryan Gardner	TELEPHONE: (951) 836-3180
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023

LIC9099 (FAS) - (06/04)

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