360902944-4-9-2024-56-AS-EMAN-D4EVVN-20240417164636

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360902944
Report Date: 04/09/2024
Date Signed: 04/09/2024 10:41:53 AM

Unfounded

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
10/09/2023 and conducted by Evaluator Melody Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20231009112450

FACILITY NAME:	INLAND CHRISTIAN HOME, INC		FACILITY NUMBER:	360902944
ADMINISTRATOR:	MARY WOLFF		FACILITY TYPE:	741
ADDRESS:	1950 SOUTH MOUNTAIN AVENUE		TELEPHONE:	(909) 983-0084
CITY:	ONTARIO	STATE: CA	ZIP CODE:	91762
CAPACITY:	297	CENSUS: 38	DATE:	04/09/2024
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Memory Care Director and Assisted Living Director Denise Perez		TIME COMPLETED:	10:50 AM

ALLEGATION(S):

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Staff are sleeping on the night shift.
Staff are not responding to residents call for assistance.

INVESTIGATION FINDINGS:

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On 04/09/2024, at 10:00 AM, Licensing Program Analyst (LPA) Melody Brown conducted an unannounced visit to the facility to deliver findings for the above allegations. LPA Brown identified herself and discussed the purpose of the visit with Memory Care Director and Assisted Living Director Denise Perez.

The investigation was conducted by LPA Brown. The investigation consisted of file review and interviews with relevant parties. The first allegation indicates Staff are sleeping on the night shift. LPA Brown conducted interviews with staffs and residents and reviewed pertinent documents. Per documents review and interviews conducted, Resident #1 (R1) was independent and resided in the Independent Living Apartments of the facility, and the allegation of “Staff sleeping on the night shift," therefore is UNFOUNDED.

Regarding allegation "Staff are not responding to residents call for assistance." LPA Brown conducted interviews with residents and staffs and reviewed pertinent documents. ***Continuation in LIC9099C***

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Melody Brown	TELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024

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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Control Number 56-AS-20231009112450

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: INLAND CHRISTIAN HOME, INC	FACILITY NUMBER: 360902944
	VISIT DATE: 04/09/2024

NARRATIVE

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Per documents review and interviews conducted, Resident #1 (R1) was independent and resided in the Independent Living Apartments of the facility, and the allegation of "Staff are not responding to residents call for assistance," therefore is UNFOUNDED.

This agency has investigated the complaint allegations. We have found that the complaint was UNFOUNDED, meaning that the allegations Staff are sleeping on the night shift (Allegation #1), Staff are not responding to residents call for assistance (Allegation #2) were false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

An exit interview was conducted with Memory Care Director and Assisted Living Director Denise Perez and a copy of this report (LIC9099), was discussed and provided.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Melody Brown	TELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024

LIC9099 (FAS) - (06/04)

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