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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361881134
Report Date: 11/30/2023
Date Signed: 11/30/2023 01:35:29 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
11/21/2023 and conducted by Evaluator Amber Coleman
COMPLAINT CONTROL NUMBER: 56-AS-20231121172525
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: 42DATE:
11/30/2023
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Patricia Gustin, Executive DirectorTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Facility Staff did not respond to resident's pendant in a timely manner.
Staff left resident in soiled diapers for an extended period of time.
Staff do not provide adequate food service to residents in care.
Staff did not ensure that facility dishes were properly sanitized.
INVESTIGATION FINDINGS:
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Licensing Program Analyst, Amber Coleman, (LPA) arrived at the Allara Senior Living Residential Care Facility for the Elderly to initiate a complaint investigation into the allegations listed above. LPA introduced self and stated purpose of the visit. LPA met with Patricia Gustin, Executive Director. Today's visit consisted of staff and resident interviews, a walk through of the facility and collection of pertinent documents.

It is alleged that facility staff did not respond to resident's call pendant in a timely manner. Observations of the facility call light system revealed that when resident's trigger their call lights, caregivers and medication technicians are notified via pager system and respond by going to the residents room. Executive Director reports that the facility is fully staffed at this time. Also, frequently works with Resident Care Director to address all staffing. During interviews residents revealed that call lights are answered within a reasonable time frame. According to Building Services Director, Mark Cunningham all personal pendants for residents and their rooms are in good condition and working order.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amber Coleman
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2023
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-20231121172525
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: ALLARA SENIOR LIVING
FACILITY NUMBER: 361881134
VISIT DATE: 11/30/2023
NARRATIVE
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It is alleged that staff left resident in soiled diapers for an extended period of time. LPA walked through the facility and did not make observation of residents being left in soiled depends. LPA did not observed lingering odors that would indicate soiled linens or depends are left unattended. Staff deny that residents are left in soiled linens and/or depends for long periods of time. Residents deny that staff leave them in soiled linens and/or depends. Residents report that all of their incontinence needs are addressed when needed.

It is alleged that staff do not provide adequate food service to residents in care. Residents report that the food services provided are adequate and meet their needs. Residents report entering the dining room, being waited on and served happen within 10 to 15 minutes of their arrival. During walk through of the dining room and kitchen, LPA observed a variety of beverages, fruits, breads, and snacks available and accessible to residents to pick up and take along with them. The dining room contained adequate amounts of seating and space for the residents in care. LPA found that the kitchen contained a sufficient amount of food for the number residents in care. LPA also observed well maintained storage spaces to house the food and food services department. Dishes, utensils and cook ware were also observed to be in good condition with proper storage. Staff denied that residents are waiting for long periods of time for assistance with eating their meals.

It is alleged that staff do not ensure the facility dishes were properly sanitized. All kitchen staff deny that they were ever advised to wash/sanitize dishware, utensils, and cook ware without proper supplies or materials to sanitize the equipment. Staff report that they have always had all supplies required to properly sanitize dishes, utensils and equipment used in food preparations. According to Building Services Director, the kitchen's dishwasher is in functional condition. All staff denied that the dishwasher was ever in disrepair. LPA observed the facility kitchen during the visit and observed kitchen equipment in working condition and adequate amounts of cleaning supplies.

Based on observations, interviews and record reviews, the above listed allegations are 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. This report was reviewed and discussed with facility representative; then provided.

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amber Coleman
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2