361880660-7-13-2022-56-AS-KCLS-CNPT3M-20230203132235

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361880660
Report Date: 07/13/2022
Date Signed: 07/13/2022 12:40:53 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
07/07/2022 and conducted by Evaluator Javier Prieto

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20220707142246

FACILITY NAME:	RIALTO ASSISTED LIVING		FACILITY NUMBER:	361880660
ADMINISTRATOR:	KYONG SUK LEE		FACILITY TYPE:	740
ADDRESS:	1441 S RIVERSIDE AVE		TELEPHONE:	(909) 877-2340
CITY:	RIALTO	STATE: CA	ZIP CODE:	92376
CAPACITY:	94	CENSUS: 45	DATE:	07/13/2022
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Kyong Suk "Clara" Lee		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Facility does not have sufficient staff to meet resident's needs.

Facility is not following resident's admission agreement

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint investigation regarding allegations that the facility does not have sufficient staff to meet resident's needs and facility is not following resident's admission agreement. LPA Prieto met with Administrator Kyong Suk "Clara" Lee to discuss the elements of the complaint. LPA Prieto obtained client #1's (C1) admissions agreement stating that bed linen are to be changed and washed once a week. LPA interviewed Housekeeping Supervisor (S1) and obtained facility cleaning schedule. Documentation will show that cleaning of client rooms are met and sufficient staff are present to perform those duties, thus abiding cleaning of resident's linens per agreement. LPA obtained staffing schedule that shows there are sufficient staff to meet the needs of the residents. LPA interviewed client #1 (C1) in question and observed C1's living quarter to be clean and with clean linens. Based on the information obtained there is not enough evidence that the facility does not have sufficient staff to meet resident's needs and facility is not following resident's admission agreement. Therefore, the allegations are deemed UNSUBSTANTIATED at this time. This report was signed be LPA Prieto and Administrator Lee and a copy was left with the facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Javier Prieto	TELEPHONE: 951-217-3135
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022

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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