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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336427235
Report Date: 05/20/2025
Date Signed: 05/20/2025 02:02:58 PM

Substantiated


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
12/23/2024 and conducted by Evaluator Melody Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20241223134640
FACILITY NAME:CORONA RESIDENTIAL CARE CENTER LLCFACILITY NUMBER:
336427235
ADMINISTRATOR:AHARON STRIKSFACILITY TYPE:
740
ADDRESS:1400 CIRCLE CITY DRTELEPHONE:
(951) 735-0252
CITY:CORONASTATE: CAZIP CODE:
92879
CAPACITY:125CENSUS: 89DATE:
05/20/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Assistant Administrator Mary GonzalezTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff did not ensure that a resident received medical and dental services.
INVESTIGATION FINDINGS:
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On 05/20/2025, Licensing Program Analyst (LPA) Melody Brown conducted an unannounced visit to the facility to deliver complaint investigation findings for the above allegation. After introducing and identifying self, LPA Brown met Assistant Administrator Mary Gonzalez to discuss the findings.

The investigation was conducted by LPA Melody Brown. The investigation consisted of file review and interviews with relevant parties. The allegation indicates that staff did not ensure that a resident received medical and dental services. LPA Brown obtained evidence to corroborate the allegation. Interview with Resident #1 (R1) on 12/30/2024 indicated that since R1 moved in at the facility in 2017, R1 did not see a dentist or have an appointment with a dentist. in addition R1 stated that R1 has an upcoming dentist appointment scheduled on 01/23/2025 which is R1 first dentist appointment since moving in at the facility in 2017. Interview with R1 Public Guardian confirmed that R1 has not seen a dentist since moving in at the facility in 2017 and discussed R1 unmet dental care needs to the facility on 12/2024. **Cont. in LIC9099C**
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
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 3
Control Number 56-AS-20241223134640
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
, CA 92507
FACILITY NAME: CORONA RESIDENTIAL CARE CENTER LLC
FACILITY NUMBER: 336427235
VISIT DATE: 05/20/2025
NARRATIVE
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Interview with six (6) of eight (8) residents revealed that they are not receiving dental services as they were not informed that they can see a dentist and they were never provided assistance to make an appointment to see a dentist since they moved in at the facility. On 12/30/2024, Staff #1 (S1) informed LPA Brown that R1's Health Insurance requires them to set-up their own appointment that's why R1 has not seen a dentist since moving in in 2017. Moreover, Staff #7 (S7) reported that when R1 has a dental appointment scheduled, R1 will not go to the scheduled appointment but there was no documentation available to prove that R1 refused to go to R1's scheduled appointment. In addition, records review revealed that R1 has a mental health condition that makes R1 unable to advocate and decide for own medical and dental care and although the facility has a plan that encourage and provide assistance in medical care to R1, LPA Brown noted that the facility does not have a plan to encourage routine dental care and provide assistance in obtaining such care to meet R1 needs.

Overall, the preponderance of evidence supports that staff did not ensure that a resident received dental services. It was found that R1 was diagnosed to have mental health condition that makes R1 unable to advocate and decide for own medical and dental care and there is lack of support to identify that the facility has a plan to encourage routine dental care and provide assistance in obtaining such care to meet R1 needs. As a result, R1 was not able to receive dental services since moving in at the facility in 2017 and investigations revealed that on 01/23/2025 was R1 first dentist appointment since moving in at the facility in 2017 after R1 Public Guardian reported to the facility R1 unmet dental care needs.

The above allegation is found to be SUBSTANTIATED. A deficiency is being issued per California Code of Regulations, Title 22. A substantiated finding means that the allegation is valid because the preponderance of evidence standard has been met.

An exit interview was conducted where this report, LIC9099, LIC9099D, and Appeal Rights were discussed and provided to Assistant Administrator Mary Gonzalez.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Citations on this Visit Report are Under Appeal!

Control Number 56-AS-20241223134640
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
, CA 92507

FACILITY NAME: CORONA RESIDENTIAL CARE CENTER LLC
FACILITY NUMBER: 336427235
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type B
05/27/2025
Section Cited
CCR
87465(a)(1)
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87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by... The plan shall encourage routine medical and dental care and provide for assistance...(1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs...This requirement was not met as evidenced by:
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Licensee stated to train all staff on CCR 87465(a)(1) and submit proof to LPA Brown by the Plan of Correctio (POC) due date.

Licensee stated that R1 had a dentist appointment on 01/23/2025.
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Based upon interviews and records review, R1 did not receive dental care since moving in at the facility on 2017 nor R1 assisted with receiving dental care as needed due to R1 mental health condition which pose a potential health, safety, and personal rights risk to resident in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC9099 (FAS) - (06/04)
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