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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361880660
Report Date: 04/14/2025
Date Signed: 10/13/2025 06:11:44 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 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
11/14/2024 and conducted by Evaluator Lavette Farlow
COMPLAINT CONTROL NUMBER: 56-AS-20241114215838
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: DATE:
04/14/2025
UNANNOUNCEDTIME BEGAN:
12:47 PM
MET WITH:Administrator, Tae KimTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Resident was illegally evicted by staff.
Staff retaliated against resident for complaining to CCL
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) LaVette Farlow conducted an unannounced visit to the facility to conclude the investigation of and deliver the findings to the above-mentioned complaint. LPA met with Administrator, Tae Kim who was informed of the reason for today's visit. The investigation consisted of observations, interviews with residents and staff and record reviews.

Allegation: It is alleged that a Resident was illegally evicted by staff. The investigation consisted of file review, interviews with staff and resident one (R1). The interview with R1 and facility staff revealed that R1 has not been following the admission agreement and house rules. R1 has also stated there has been past and recent incidents with other residents and destruction of facility property.

On 06/23/2023, a written warning was given to R1. Interviews with staff revealed that R1 has had incidents with other residents in care. It is alleged that R1 made verbal threats to a resident, and staff observed R1 to be under the influence of alcohol.
***Continued on LIC9099C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2025
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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Control Number 56-AS-20241114215838
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: RIALTO ASSISTED LIVING
FACILITY NUMBER: 361880660
VISIT DATE: 04/14/2025
NARRATIVE
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LPA observed documentation that revealed the facility started the eviction process.
LPA observed the eviction notice and it appeared to follow the regulations regarding the eviction procedure. On September 12, 2024, resident was served a 60 Day Notice of Termination of Tenancy. LPA observed that R1 still resided at the facility after the eviction date. LPA received documentation stating R1 doctor requested that R1 be admitted into the hospital. R1 refused medical treatment and on November 17, 2024, R1 was transported to the hospital via paramedics. It was reported that R1 did not return to the facility after being discharged from hospital.

Allegation: It is alleged that staff retaliated against residents for complaining to CCL. LPA interviewed 6 out of 6 residents in care and based on the interviews 6 out of 6 residents stated they have not seen, or experienced staff retaliate against residents. LPA interviewed 6 out of 6 staff and based on the interviews with staff it was revealed that staff have not retaliated against residents in care, or have they seen any retaliation. Based on LPA interview with R1, R1 stated the Administrator retaliated against R1. R1 was unable to give examples of retaliations. LPA Farlow observed staff assisting R1 and observed documentation of R1 scheduled appointments and cleanliness of R1 room.

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.

An exit interview was conducted where this report LIC 9099 and LIC 9099C was discussed, and a copy was provided to Administrator Tae Kim.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2025
LIC9099 (FAS) - (06/04)
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