361880660-10-30-2025-56-AS-NBRN-DVJTW3-20260630150452

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361880660
Report Date: 10/30/2025
Date Signed: 10/30/2025 04:29:48 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
10/24/2025 and conducted by Evaluator Lavette Farlow

COMPLAINT CONTROL NUMBER: 56-AS-20251024163256

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: 57	DATE:	10/30/2025
		UNANNOUNCED	TIME BEGAN:	12:52 PM
MET WITH:	Tae Kim, Administrator		TIME COMPLETED:	04:35 PM

ALLEGATION(S):

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Staff did not prevent resident from smoking in non-smoking areas of the facility.
Staff did not assist resident with incontinence care needs in a timely manner.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) LaVette Farlow conducted an unannounced visit to the facility to conduct an investigation for the above mentioned allegations. LPA met with Office Assistant, Beverly Robertson and was escorted to the library. Beverly informed LPA that Administrator, Tae Kim was at lunch and she would notify him of my presents. LPA explained to Beverly, and later to Administrator of the reason for today's visit. The investigation consisted of observations, interviews with residents and staff and record review.

Allegation 1: It is alleged that staff did not prevent resident from smoking in non-smoking areas of the facility. R1 stated staff have spoken to them several times about smoking in my room. R1 stated staff do assist in taking R1 outside for a cigarette break. R1 stated it took another resident talking with me to realize how dangerous it is. LPA interviewed six (6) out of (6) staff, and six (6) out of six (6) staff stated several staff have spoken to R1 about smoking in the room, the safety hazards and that it is not allowed.
***Continued LIC9099C***

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2025

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-20251024163256

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: 10/30/2025

NARRATIVE

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S1, S4, and S5, reported that R1 cigarettes were confiscated and are maintained at the front desk. S1, S4, and S5 stated now staff give R1 cigarettes just before going out for a smoke. S4 reported that R1 asked for a room change, because R1's roommate smoke cigarette and when R1's roommate would return to the room the smell of the cigarette smoke was very tempting and hard for R1 not to smoke. Based on interviews with residents and staff the allegation is UNSUBSTANTIATED.

Allegation 2: Staff did not assist resident with incontinence care needs in a timely manner. LPA interviewed R1 and six (6) staff. R1 stated that he likes it here. R1 stated staff are pretty good about changing me. R1 stated, I don't lay in pee. LPA interviewed six (6) out of six (6) staff and it was revealed that staff change R1 every 2 hours sometimes more. Several staff reported that R1 will attempt to used the urinal and often times spills urine in the bed shortly after changing R1. Several staff reported R1 only has mobility in one arm and often times spills coffee as well. Several Caregivers and Med-Tech's reported that R1 will refuse staff assistance on the NOC shift. Based on interviews with residents and staff the allegation is UNSUBSTANTIATED.

Based on the information above, the allegations is unsubstantiated. 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 violations did or did not occur. An exit interview was conducted where this report LIC9099 and LIC9099C was discussed, and a copy was provided to Administrator Tae Kim.

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2025

LIC9099 (FAS) - (06/04)

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