361880786-12-14-2023-56-AS-KCLS-CPKTFD-20230303134118

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361880786
Report Date: 02/28/2023
Date Signed: 12/14/2023 02:10:51 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
11/02/2022 and conducted by Evaluator Bernadette Allen

COMPLAINT CONTROL NUMBER: 56-AS-20221102154307

FACILITY NAME:	SUMMERFIELD OF REDLANDS		FACILITY NUMBER:	361880786
ADMINISTRATOR:	TURNER, DANICA J		FACILITY TYPE:	740
ADDRESS:	1319 BROOKSIDE AVENUE		TELEPHONE:	(909) 793-9500
CITY:	REDLANDS	STATE: CA	ZIP CODE:	92373
CAPACITY:	75	CENSUS: 44	DATE:	02/28/2023
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Hedi Charette Administrator		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Facility staff handled resident in a rough manor

INVESTIGATION FINDINGS:

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On 12/14/2023 Licensing Program Analyst (LPA) Bernadette Allen met with Hedi Charette Administrator at the Adult & Senior Care Regional Office to deliver the findings for a complaint investigation conducted by the Department.

The Department investigated the allegation that facility staff handled Resident #1 (R1) in a rough manner.
The investigation consisted of review of R1's medical record, facility files review, Department reports, Interviews with facility staff and relevant parties.
According to the complaint, it was reported that there was an incident between a facility staff and R1 that occurred on 10/29/2022. It is alleged that during this incident, R1 sustained injuries. On the morning of 10/30/2022, facility staff contacted R1’s responsible party to inform them that R1’s hands were swollen and bruised. According to reports, R1’s right hand appeared to show more bruising than the left hand. On 11/1/2022, a mobile imaging technician came to the facility and took x-rays of R’1s right hand.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Bernadette Allen	TELEPHONE: 951-897-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2023

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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Control Number 56-AS-20221102154307

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
, CA 92507

FACILITY NAME: SUMMERFIELD OF REDLANDS	FACILITY NUMBER: 361880786
	VISIT DATE: 02/28/2023

NARRATIVE

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According to the x-ray results, no fracture or broken bones were detected. On 11/4/2022, R1’s primary care physician ordered x-rays of both hands and results showed a right-hand fracture.

In regard to the allegation that facility staff handled R1 in a rough manner, the circumstances surrounding the incident between staff and R1 and how R1 sustained injuries was not supported by witnesses or other preponderance of evidence. In addition, there were no records, facility reports, progress notes, or documentation provided or available for review to determine what occurred from the time of the first x-ray on 11/01/2022 to the diagnosis of right-hand fracture on 11/04/2022.

As a result, the allegation that facility staff handled resident in a rough manner is 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 where a copy of this report with appeal rights was provided to Hedi Charette at the conclusion of the visit.

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Bernadette Allen	TELEPHONE: 951-897-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2023

LIC9099 (FAS) - (06/04)

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