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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361880835
Report Date: 07/19/2022
Date Signed: 07/19/2022 11:42:35 AM

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
06/08/2022 and conducted by Evaluator Anna Bueno
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20220608092313
FACILITY NAME:VISTA BLUE MOUNTAINFACILITY NUMBER:
361880835
ADMINISTRATOR:PENDINGFACILITY TYPE:
740
ADDRESS:22325 BARTON ROADTELEPHONE:
(909) 420-0153
CITY:GRAND TERRACESTATE: CAZIP CODE:
92313
CAPACITY:150CENSUS: 70DATE:
07/19/2022
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Tara TaylorTIME COMPLETED:
11:46 AM
ALLEGATION(S):
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9
Staff did not provide adequate food service
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced visit to this facility to conduct additional interviews, observations of teh kitchen, and deliver findings on the allegations listed above. LPA Bueno met with resident care director, Tara Taylor, who was informed the purpose of today’s visit.

The complaint alleges that staff did not provide adequate food service. Records reviewed included menu from 2/28/22 through 6/18/22 that were approved by a registered dietitian nutritionist and weekly purchase orders from a wholesale food vendor. Staff interviews revealed that the facility menu is created by a third party company who employs the registered dietitian nutritionist. LPA observed that kitchen is serving pasta and fresh vegetables for lunch and residents' diet restriction and/or allergies information are posted along the food prep area. For these reasons, the allegation is UNSUBSTANTIATED.

A finding of unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted with Ms. Taylor and telephonically with administrator Niare Feaster and a copy of this report was provided to Ms. Taylor.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Anna BuenoTELEPHONE: 951-204-4307
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022
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 2
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
06/08/2022 and conducted by Evaluator Anna Bueno
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20220608092313

FACILITY NAME:VISTA BLUE MOUNTAINFACILITY NUMBER:
361880835
ADMINISTRATOR:PENDINGFACILITY TYPE:
740
ADDRESS:22325 BARTON ROADTELEPHONE:
(909) 420-0153
CITY:GRAND TERRACESTATE: CAZIP CODE:
92313
CAPACITY:150CENSUS: 70DATE:
07/19/2022
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Tara TaylorTIME COMPLETED:
11:46 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility doesn't have an Administrator
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced visit to this facility to deliver findings on the allegations listed above. LPA Bueno met with resident care director Tara Taylor, who was informed the purpose of today’s visit.

The complaint alleges that the facility does not have an administrator. This facility notified the Department on March 18, 2022 that the facility had an interim administrator as of March 16, 2022 and their administrator license is current. LPA Bueno verified that the administrator has an active certificate valid through July 29, 2022.

This allegation is UNFOUNDED, meaning that the allegation isa false, could not have happened and/or is without a reasonable basis. An exit interview was conducted with Ms. Taylor and telephonically with administrator Niare Feaster and a copy of this report was provided to Ms. Taylor.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Anna BuenoTELEPHONE: 951-204-4307
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 2