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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361881134
Report Date: 05/16/2025
Date Signed: 05/16/2025 02:38:12 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
04/22/2025 and conducted by Evaluator Renese Howell-Small
COMPLAINT CONTROL NUMBER: 56-AS-20250422164144
FACILITY NAME:ALLARA SENIOR LIVINGFACILITY NUMBER:
361881134
ADMINISTRATOR:HEFNER, LEEANNFACILITY TYPE:
740
ADDRESS:9417 19TH STREETTELEPHONE:
(909) 736-1900
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91701
CAPACITY:120CENSUS: 102DATE:
05/16/2025
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Resident Care Director, Jessica PadronTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Staff do not distribute residents' medications as prescribed
Staff handled resident in a rough manner
INVESTIGATION FINDINGS:
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On 05/15/2025 at 1:30PM Licensing Program Analyst (LPA) Renese Howell-Small conducted an unannounced visit to the facility in order to deliver findings for the above allegations. LPA discussed the purpose of the visit with Resident Care Director, Jessica Padron. The investigation consisted of interviews and record review.

In regards to the allegation of staff do not distribute residents' medications as prescribed:

LPA interviewed ten (10) staff, (5) residents and relatives of residents. All of staff have denied the allegation stating that they have been trained and follow the facility policy if an error is made with medication. Staff stated that most residents are aware of what medications are needed and when they need to be taken. Residents stated that they received their medication and do not have any concerns. The relatives of residents have stated that their family member receives their medication as prescribed. LPA audited residents’ medication and reviewed the Medication Administration Record (MAR) and did not observe any issues or concerns. Based on interviews, observation and record review, this allegation is UNSUBSTANTIATED.


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2025
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
Control Number 56-AS-20250422164144
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: ALLARA SENIOR LIVING
FACILITY NUMBER: 361881134
VISIT DATE: 05/16/2025
NARRATIVE
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In regards to the allegation of staff handled resident in a rough manner:

LPA interviewed ten (10) staff, five (5) residents and relatives of residents.
All of the staff that were interviewed denied the allegation of handling resident in a rough manner. Residents are treated kindly and with respect. Residents and their relatives have stated that staff are great and treat the residents well. They denied witnessing staff handle residents in a rough manner. Based upon interviews, this allegation is UNSUBSTANTIATED.

UNSUBSTANTIATED is defined as the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted where this report LIC9099, LIC9099C was discussed and a copy was provided to Business Office Director, Helen Jaquez.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2025
LIC9099 (FAS) - (06/04)
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