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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336427235
Report Date: 05/29/2025
Date Signed: 05/29/2025 03:53:26 PM

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
09/12/2024 and conducted by Evaluator Melody Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240912101826
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: 90DATE:
05/29/2025
ANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Assistant Administrator Mary GonzalezTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff neglect resulted in a resident to be hospitalized.
Staff is over medicating a resident.
INVESTIGATION FINDINGS:
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On 05/29/2025 at 03:00 PM, Licensing Program Analyst (LPA), Melody Brown, met with Assistant Administrator Mary Gonzalez at Community Care Licensing Division (CCLD) Adult and Senior Care (ASC) San Bernardino (SB) Regional Office to deliver the complaint investigation findings for the above allegations. After introducing and identifying self, LPA Brown met Assistant Administrator Mary Gonzalez and explained the purpose of the requested Office Visit.

The investigation was conducted by LPA Melody Brown. The investigation consisted of file review and interviews with relevant parties. The first allegation indicates staff neglect resulted in a resident to be hospitalized. During the investigation, LPA Brown was not able to obtain sufficient evidence to support that staff neglect resulted in a resident to be hospitalized. LPA Brown unable to interview Resident #1 (R1) as R1 moved out at the facility on 10/01/2025. Interview with seven (7) of seven (7) residents indicated that staff at the facility are checking on them multiple times in a day. Staff interviewed reported that they are checking on all their residents every two (2) hours, ***Continuation in LIC9099C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2025
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 2
Control Number 56-AS-20240912101826
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: 05/29/2025
NARRATIVE
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every hour or every 30 minutes. Six (6) of six (6) staff interviewed revealed that they are checking on R1 at least every two (2) hours or more often if needed. All staff interviewed denied that R1 was neglected. Interview with Staff #1 (S1) indicated that R1 was sent out to the hospital in 09/12/2024 due to shortness of breath and mumbling words. Medical Records review revealed that the facility sent out R1 to the hospital after a staff observed R1 change of condition. Moreover, R1 was treated at the hospital for complaints and symptoms that are not keeping R1 with R1 overall wellness and condition. R1 was discharged to skilled nursing facility for continuation of care. In addition, records review revealed that on 06/23/24, R1 was diagnosed and being treated for a medical condition that can cause skin breakdown with possible bleeding in R1 lower extremity. It was noted that R1 has monthly follow-up appointments with R1 physician.

The second allegation indicates staff is over medicating a resident. During the investigation, LPA Brown did not find any evidence to corroborate the allegation. LPA Brown was unable to interview R1 due to resident no longer living at the facility. Interview with seven (7) residents indicated that staffs are dispensing their medications as prescribed and there's no incident that staff over medicated a resident. Six (6) staff interviewed reported they have not witnessed or heard of an incident that a staff over medicating a resident.

Two (2) Medication Technician (MedTech) staffs added that they are utilizing electronic Medication Administration Record (MAR) to ensure that they are giving the residents medications as prescribed. Both MedTechs denied over medicating R1. LPA Brown reviewed R1’s MAR and confirmed that staffs are dispensing R1's medications per R1’s physician orders and there was no evidence that staff overmedicated R1.

Based on the evidence, the allegation that Staff neglect resulted in a resident to be hospitalized (Allegation #1), and Staff is over medicating a resident (Allegation #2) are UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means 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, therefore the allegation is unsubstantiated at this time.

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

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

DATE: 05/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2