361800147-2-28-2022-18-AS-KCLS-CD7NGH-20220405102709

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361800147
Report Date: 02/28/2022
Date Signed: 02/28/2022 02:43:54 PM

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
02/22/2022 and conducted by Evaluator Ryan Gardner

COMPLAINT CONTROL NUMBER: 18-AS-20220222112449

FACILITY NAME:	MONTCLAIR ROYALE SENIOR LIVING		FACILITY NUMBER:	361800147
ADMINISTRATOR:	SANTOS, ANNAMARIE		FACILITY TYPE:	740
ADDRESS:	9685 MONTE VISTA AVE		TELEPHONE:	(909) 621-3545
CITY:	MONTCLAIR	STATE: CA	ZIP CODE:	91763
CAPACITY:	236	CENSUS: 127	DATE:	02/28/2022
		UNANNOUNCED	TIME BEGAN:	01:26 PM
MET WITH:	Araceli Soto- Care Coordinator		TIME COMPLETED:	02:48 PM

ALLEGATION(S):

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Facility mismanaging residents' funds.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Ryan Gardner and Anna Bueno arrived at the facility unannounced to commence a complaint investigation and deliver the findings for the complaint allegation. LPAs met with Care Coordinator, Araceli Soto.

After interviews, record review, and gathering evidence, it was determined that the residents' money is not managed by the facility. Resident is on an Assisted Living Wavier Program that helps cover the residents monthly rent. The facility does not manage personal money for residents. Thus, the allegation was deemed to be UNFOUNDED.

LPAs determined that the allegation, "Facility mismanaging residents' funds" was deemed to be UNFOUNDED. A finding of UNFOUNDED means that the allegations were false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted, and a copy of this report was given to Araceli Soto. LPA did not observe any violations of Title 22 during this visit.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 836-2784
LICENSING EVALUATOR NAME: Ryan Gardner	TELEPHONE: (951) 248-0336
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2022

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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