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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361880660
Report Date: 12/17/2021
Date Signed: 12/17/2021 05:59:41 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:RIALTO ASSISTED LIVINGFACILITY NUMBER:
361880660
ADMINISTRATOR:KYONG SUK LEEFACILITY TYPE:
740
ADDRESS:1441 S RIVERSIDE AVETELEPHONE:
(909) 877-2340
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY:94CENSUS: 48DATE:
12/17/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
06:00 PM
MET WITH:Kyong "Clara" Suk Lee - AdministratorTIME COMPLETED:
06:15 PM
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Licensing Program Analyst (LPA ) Crystal Colvin arrived at the facility unannounced for the purpose of following up on multiple complaints. During LPA Colvin's inspection, LPA Colvin reviewed the Resident Council meeting notes and observed in the notes from the meeting on 8/20/21, that in the Council's "New Business" the following item was listed as item "C." in "Kitchen issues": "If you are too late to meals you may not be served".

LPA Colvin advised the Administrator that residents are not to be denied meals or food service regardless of whether or not they arrive on time to the dining room. LPA Colvin is issuing a Technical Violation Advisory Note today instead of a deficiency, as LPA Colvin does not know at this time if any resident has been denied food service due to being late.

An exit interview was conducted with Administrator Kyong "Clara" Suk Lee and a copy of this report, Technical Violation Advisory Note (LIC9102-AN) were provided.
SUPERVISOR'S NAME: Joel EsquivelTELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Crystal ColvinTELEPHONE: (951) 204-0848
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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