336427235-6-18-2021-18-AS-NBRN-C54P7V-20210720110432

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336427235
Report Date: 06/18/2021
Date Signed: 06/18/2021 02:44:19 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
06/10/2021 and conducted by Evaluator Amy Goldenberg

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20210610104802

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: 64	DATE:	06/18/2021
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Mary		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility does not have adequate staffing to meet residents' needs.
Facility is not serving food of the quality to meet the residents' needs.
Staff are not managing residents' incontinence needs.
Facility has roaches.
Staff are not properly disposing of trash.
Administrator is not enforcing community/house rules.
Facility is dirty.

INVESTIGATION FINDINGS:

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This unannounced visit conducted by Amy Goldenberg, Licensing Program Analyst (LPA), is being conducted to initiate the 10 day visit to investigate the above mentioned complaint allegations. LPA met with Administrator Mary to discuss the elements of the alleged violations.

During this investigation LPA toured the facility, including the common areas, hallways, selected resident bedrooms, the kitchen, the food supply, laundry area and the medication room. It is alleged that the facility is not maintaining residents incontinent needs due to staffing being inadequate. Review of facility staffing schedule and interviews conducted do not support the alleged violation. It is alleged that residents are also left in dirty diapers for longer than they should, and they do not get the individual proper care they should.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Nedra Brown	TELEPHONE: (951) 248-0339
LICENSING EVALUATOR NAME: Amy Goldenberg	TELEPHONE: (951) 248-0351
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

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-20210610104802

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: CORONA RESIDENTIAL CARE CENTER LLC	FACILITY NUMBER: 336427235
	VISIT DATE: 06/18/2021

NARRATIVE

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Four (4) out of six (6) residents interviewed receive incontinent care and reported that their incontinent care needs are being met by the facility. It is alleged that the facility is serving expired food items to residents and that the ice machine has cockroaches and mold. LPA reviewed the facility pest control contract with Orkin, refrigerated storage guide, produce storage guidelines, ice cleaning machine procedure and sign off sheet. LPA made visual observations of the kitchen, food supply and two (2) ice machines. LPA learned the following information: The ice machine is scheduled to be cleaned per procedure one time per month. Sign in sheet reveals that this has been signed as being done monthly. LPA did not observe that the ice machine was moldy or any signs of cockroaches in the facility or ice maker. LPA review of stored food items did not reveal any expired or spoiled foods. The facility receives food orders three times per week and the food stores are rotated first in first out basis according to dietary services guidelines. It is alleged that the facility is not disposing trash properly and that the facility is dirty. LPA began the visit with a tour of the facility. LPA observed large trash bins with lids available in each hallway. LPA observed that the trash cans are closed and are not overflowing. LPA observed house keeping and janitorial staff tending to the facility environment upon arrival. Trash cans in resident bedrooms are not overflowing. LPA observed that the facility floors are clean and free of debris. LPA observed the bathrooms, closets, and bedrooms of selected rooms are clean. LPA learned through interviews that house keeping comes often to clean the resident rooms. LPA observed the kitchen to be clean and free of vermin. LPA Notes that other than normal wear and tearing of facility flooring there are no observable signs that the facility is dirty. In regard to administrator is not enforcing community/house rules, LPA was unable to find corroborating information to this allegation, although it was admitted that some residents do violate the house ruled. The administrator reports that house rules are enforced with violation notification, that a family meeting would be held to resolve the behavior and that if violation of the house rules continued eviction procedures would be pursued.

We have found the complaint allegations are unsubstantiated, although the allegations may have happened or are 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.

SUPERVISOR'S NAME: Nedra Brown	TELEPHONE: (951) 248-0339
LICENSING EVALUATOR NAME: Amy Goldenberg	TELEPHONE: (951) 248-0351
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

LIC9099 (FAS) - (06/04)

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