361880786-12-24-2024-56-AS-EMAN-DG8N5A-20250430100914

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361880786
Report Date: 12/24/2024
Date Signed: 12/24/2024 02:24:37 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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
05/23/2024 and conducted by Evaluator Paola Guerrero

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240523081611

FACILITY NAME:	SUMMERFIELD OF REDLANDS		FACILITY NUMBER:	361880786
ADMINISTRATOR:	HEDI CHARETTE		FACILITY TYPE:	740
ADDRESS:	1319 BROOKSIDE AVENUE		TELEPHONE:	(909) 793-9500
CITY:	REDLANDS	STATE: CA	ZIP CODE:	92373
CAPACITY:	75	CENSUS: 48	DATE:	12/24/2024
		UNANNOUNCED	TIME BEGAN:	12:42 PM
MET WITH:	Jonathan Guzman		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Resident developed a pressure injury while in care.
Staff do not ensure resident care needs are being met.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Facility Business Office Manager (BOM), Jonathan Guzman, and explained the purpose of the visit. The investigation consisted of interviews and review of records.

First allegation: Resident developed a pressure injury while in care. Regarding the allegation stated above LPA conducted a record LPA discovered that R#1 was being treated for stage #2 pressure injury along with elbow skin tear by Inland Valley Hospice. LPA review medication record and discovered that cream was prescribed to R#1 to help treat R#1 affected areas. LPA conducted interview with S#1 who informed LPA that R#1 was being treated for pressure injury according to resident treatment plan.

Second allegation: Staff do not ensure resident care needs are being met. Regarding the allegation stated above LPA conducted a review of R#1 records and discovered that Resident #1 was bedbound and required to be repositioned every two hours based on R#1 care needs.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Paola Guerrero	TELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:	DATE: 12/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/24/2024

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-20240523081611

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: SUMMERFIELD OF REDLANDS	FACILITY NUMBER: 361880786
	VISIT DATE: 12/24/2024

NARRATIVE

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LPA conducted an interview with S#1 who informed LPA that R#1 was being repositioned 2-hours and facility staff was following hospice treatment according to R#1 treatment plan. S#1 informed LPA about being present when R#1 was being repositioned. LPA conducted interviews with S#2, S#3, and S#4 who informed LPA that staff support has been consistent. S#3, and S#4, informed LPA that facility does a good job on hiring staff, and that they have not witness facility being low on staffing support. LPA conducted interviews with R#2, R#3, and R#4, all residents informed LPA that they have lived at the facility for over two years and have no concerns regarding their care. R#2, R#3, and R#4, informed LPA that facility has enough caregivers that help meet resident care needs every day. Based on corroborating evidence obtained during the course of the investigation, LPA has determined that the above allegation is Unsubstantiated.

Unsubstantiated: meaning that 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 this report (LIC 9099) was discussed, and a copy was provided to
Facility Business Office Manager Jonathan Guzman at the end of the visit.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Paola Guerrero	TELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:	DATE: 12/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/24/2024

LIC9099 (FAS) - (06/04)

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