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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361880660
Report Date: 12/17/2021
Date Signed: 08/07/2023 03:33:37 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
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/03/2020 and conducted by Evaluator Crystal Colvin
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20201203110823
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
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Kyong "Clara" Suk Lee - AdministratorTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Facility staff did not ensure that residents have towels
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Anna Bueno conducted a subsequent visit to the facility to deliver findings on the above allegation. LPA met with administrator Tae Kim who was informed of the purpose of today’s visit. The investigation consisted of resident interviews.

The allegation is Facility staff did not ensure that residents have towels. On 12/17/2021, LPA Crystal Colvin stated that on 12/10/20, the facility only had one clean towel in the laundry room (where spare towels and linen are kept). While it is likely that additional towels were on hand with the housekeepers who clean the resident bedrooms throughout the day and replace the linens, this would not be sufficient if most residents needs their towels changed out. During today's visit, LPA Bueno conducted resident interviews and discovered that the facility provides laundry services once a week and on an as needed basis, even during times of Covid-19 outbreak. Interviews with residents also reveal that, while the facility provides linens and towels, residents may purchase, store, use, and clean their own items. This allegation is therefore unsubstantiated.

A finding of UNSUBSTANTIATED means, although the allegation 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 with and a copy of this report was provided to Administrator Tae Kim.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Anna BuenoTELEPHONE: (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.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 18-AS-20201203110823
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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 LIVING
FACILITY NUMBER: 361880660
VISIT DATE: 12/17/2021
NARRATIVE
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Due to observations made by LPA Colvin, the facility was cited and deficiency noted on LIC 9099 D. An exit interview was conducted where this report and appeal rights were discussed. A copy of all reports, forms, and appeal rights were provided to Administrator Kyong "Clara" Suk Lee during the exit interview.
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
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20201203110823
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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 LIVING
FACILITY NUMBER: 361880660
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/17/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/31/2021
Section Cited
CCR
87307(a)(3)(C)
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Personal Accommodations and Services: (a) Living accommodations...shall be related to the facility's function...The following provisions shall apply: (3)...the licensee shall assure provision of: (C)...bath towels, hand towels and wash cloths. The quantity shall be sufficient... This requirement was not met by:
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Licensee agrees to institute a regular audit of the facility's linens and towels to ensure that the facility has plenty of supplies at all times. Licensee to submit an updated Program Plan (Adendum) which includes which staff role is responsible for the audit, how frequently it will occur, and what number of items need to be
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Based on interviews and internal audit, the Licensee did not comply with the above regulation with at least one category of item. LPA Colvin confirmed that the facility did not have a sufficient supply of towels, as there was only one spare clean towel. This was a potential health risk to all residents in care.
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available at all times. Porgram Plan Adendum to be submitted to LPA Colvin by the Plan of Correction date of 12/31/21. Along with the Adendum, the Licensee shall submit their first audit of the towels/linens.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
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 appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3