361880660-8-16-2023-18-AS-NBRN-CUTLRR-20230818085934

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361880660
Report Date: 08/16/2023
Date Signed: 08/16/2023 12:32:21 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
04/12/2021 and conducted by Evaluator Anna Bueno

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20210412145930

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: 52	DATE:	08/16/2023
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Irene Silva - Office Assistant		TIME COMPLETED:	12:35 PM

ALLEGATION(S):

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Staff is under the influence while providing care and supervision to resident's.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Anna Bueno conducted a subsequent unannounced visit to the facility to continue the complaint investigation of and deliver findings on the above allegation. LPA met with office assistant Irene Silva who was informed of the purpose of today’s visit. Ms. Silva electronically informed administrator Tae Kim of LPA's visit. The investigation consisted of resident and staff interviews and records review.

The allegation is Staff (S1) is under the influence while providing care and supervision to resident's. It is alleged that S1 smoke marijuana on the job. Interviews with staff deny using any substance at work. Resident interview confirm that S1 has not worked at this facility for more than a year. LPA reviewed records confirming that S1 is no longer associated to this facility. This allegation is therefore UNSUBSTANTIATED.

A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. This report was reviewed with facility representative.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Nedra Brown	TELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Anna Bueno	TELEPHONE: 951-204-4307
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

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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