360900455-3-1-2022-18-AS-KCLS-CCJQ3K-20220315114848

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360900455
Report Date: 03/01/2022
Date Signed: 03/01/2022 09:46:32 AM

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
01/26/2022 and conducted by Evaluator Javier Prieto

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20220126144145

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: 37	DATE:	03/01/2022
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Jackie Sihotang		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Visitors denied entry into facility due to COVID
Staff spoke rudely to resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conclude a complaint investigation regarding allegations that visitors denied entry into facility due to COVID and staff spoke rudely to resident.
LPA Prieto met with administrator Lisa Leak. Based on interviews with staff and confidential witness it was concluded that resident in question does not reside at this assisted living facility nor was the confidential witness denied entry into the assisted living facility. LPA was allowed into the facility following COVID protocols.

This agency has investigated the complaint alleging that visitors denied entry into facility due to COVID and staff spoke rudely to resident violations. We have found that the complaint was UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: 9512480349(323) 981-3968
LICENSING EVALUATOR NAME: Javier Prieto	TELEPHONE: 951-217-3135
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022

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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