361880835-3-9-2023-56-AS-NBRN-CRPUBD-20230510152610

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361880835
Report Date: 03/09/2023
Date Signed: 03/09/2023 01:02:11 PM

Unfounded

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
03/01/2023 and conducted by Evaluator Amy Goldenberg

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20230301131449

FACILITY NAME:	VISTA BLUE MOUNTAIN		FACILITY NUMBER:	361880835
ADMINISTRATOR:	ASHLEY WILLETT		FACILITY TYPE:	740
ADDRESS:	22325 BARTON ROAD		TELEPHONE:	(909) 420-0153
CITY:	GRAND TERRACE	STATE: CA	ZIP CODE:	92313
CAPACITY:	150	CENSUS: 51	DATE:	03/09/2023
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Ashley Willett, Executive Director		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Residents are not allowed visitors.
Residents are being transferred without resident's consent.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Amy Goldenberg is conducting this initial 10 day visit to initiate investigation into the allegations noted above. LPA met with Resident Care Director Marnee Bivens and Executive Director Ashley Willett to disclose the nature of the alleged violations. During this visit LPA requested copies of the resources and 60-day notice to terminate provided to the residents. It is alleged that S1 told the reporting party (RP) that residents R1, R2, and R3 had moved from the facility. Investigation revealed the following: One (R1) of the three (3) residents is available for interview. R2 and R3 are no longer with the community. R1 tells LPA that they have not been denied visitors and that the facility provided them with a list of resources along with their 60-day notice to terminate on 03/01/2023. R1 denies knowing the RP. S1 denies the alleged violation, reporting that they indicated that it is policy to check with the resident prior to acknowledging that the residents live in the facility to protect their rights from unknown visitors.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Nedra Brown	TELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Amy Goldenberg	TELEPHONE: (951) 201-3990
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

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-20230301131449

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: VISTA BLUE MOUNTAIN	FACILITY NUMBER: 361880835
	VISIT DATE: 03/09/2023

NARRATIVE

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It is alleged that all residents are being moved to the one community without the residents input. Review of the documentation received provides a list of assisted living communities within a 60 mile radius. On this date LPA observed that residents are being assessed from different communities for pre-placement. There is no corroborating evidence to support the alleged violations as they are reported.

We have found the complaint allegations are unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint. A copy of this report is being reviewed with, and furnished to the facility representative.

SUPERVISOR'S NAME: Nedra Brown	TELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Amy Goldenberg	TELEPHONE: (951) 201-3990
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

LIC9099 (FAS) - (06/04)

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