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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 360904812
Report Date: 09/25/2023
Date Signed: 09/25/2023 01:30:40 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
09/18/2023 and conducted by Evaluator Bernadette Allen
COMPLAINT CONTROL NUMBER: 56-AS-20230918122944
FACILITY NAME:PLYMOUTH VILLAGE OF REDLANDSFACILITY NUMBER:
360904812
ADMINISTRATOR:MICHAELS, JULIEFACILITY TYPE:
741
ADDRESS:900 SALEM DRIVETELEPHONE:
(909) 793-1233
CITY:REDLANDSSTATE: CAZIP CODE:
92373
CAPACITY:303CENSUS: 237DATE:
09/25/2023
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Julie Michaels-Executive Director TIME COMPLETED:
11:45 AM
ALLEGATION(S):
1
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9
Facility did not safeguard resident's personal items.
INVESTIGATION FINDINGS:
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12
13
Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to initiate and deliver findings for the mentioned allegations. LPA Allen met Julie Michaels-Executive Director who was informed of the purpose of the visit and allegations.

LPA conducted interviews with outside parties, staff members and resident 1(R1).
The interview with R1 stated that some personal items had been taken from their home in the past by staff member(s). R1 stated the facility has replaced the locks on their doors and they have been reassigned new staff and there has not been any items taken from the home in over two (2) years. Outside parties were interviewed and they also stated the locks had been changed and additional precautions will be put in place to ensure the safety and concerns of R1. The facility staff also stated the locks had been changed and staff had been reassigned to address R1’s concerns.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2023
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-20230918122944
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: PLYMOUTH VILLAGE OF REDLANDS
FACILITY NUMBER: 360904812
VISIT DATE: 09/25/2023
NARRATIVE
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Based on the interviews with the outside parties, resident 1 and staff members. The facility has taken precautions to safeguard the president’s personal items. Therefore, the above finding is Unsubstantiated. A finding of unsubstantiated means although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2