360900455-2-26-2024-56-AS-KCLS-D3SMJX-20240328093953

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360900455
Report Date: 02/26/2024
Date Signed: 02/26/2024 03:19:30 PM

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
02/21/2024 and conducted by Evaluator Magda Malcore

COMPLAINT CONTROL NUMBER: 56-AS-20240221152527

FACILITY NAME:	HERITAGE GARDENS		FACILITY NUMBER:	360900455
ADMINISTRATOR:	LEAK, LISA		FACILITY TYPE:	740
ADDRESS:	25271 BARTON RD		TELEPHONE:	(909) 796-0219
CITY:	LOMA LINDA	STATE: CA	ZIP CODE:	92354
CAPACITY:	64	CENSUS: 56	DATE:	02/26/2024
		UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Jessica Ramos		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Staff are not providing resident their medications as prescribed.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced visit to the facility to conduct a complaint investigation. LPA met with Jessica Ramos, LVN, and explained the purpose of the visit.

Regarding the allegation, staff are not providing resident their medications as prescribed, it is alleged that staff are intentionally not providing resident with their medications. Six (6) staff interviewed deny not providing resident their medications as prescribed. Five (5) out of (6) residents interviewed stated that staff are providing their medications at prescribed.

Based on evidence obtained during this investigation, the allegation above is Unsubstantiated; 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.
An exit interview was conducted and a copy of this report was provided to Jessica Ramos at the conclusion of the visit.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Magda Malcore	TELEPHONE: 951-248-0316
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2024

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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