361881134-3-21-2023-56-AS-KCLS-CQSTSX-20230411145953

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361881134
Report Date: 03/21/2023
Date Signed: 03/21/2023 01:47:51 PM

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
03/11/2022 and conducted by Evaluator Bernadette Allen

COMPLAINT CONTROL NUMBER: 56-AS-20220311163213

FACILITY NAME:	ALLARA SENIOR LIVING		FACILITY NUMBER:	361881134
ADMINISTRATOR:	HEFNER, LEEANN		FACILITY TYPE:	740
ADDRESS:	9417 19TH STREET		TELEPHONE:	(909) 736-1900
CITY:	RANCHO CUCAMONGA	STATE: CA	ZIP CODE:	91701
CAPACITY:	120	CENSUS: 62	DATE:	03/21/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	LeeAnn Hefner Administrator		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff only provide assistance to residents once daily
Facility does not have a call system for resident to contact staff
Resident was abandoned by staff during an emergency
Staff denied resident visits

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bernadette Allen made an unannounced visit to the facility to commence a complaint investigation and deliver findings. LPA identified herself and discussed the purpose of the visit and the elements of the allegations with Lee Ann Hefner, Administrator.

Allegation 1: Staff only provide assistance to residents once daily

LPA interviewed five (5) residents who said staff are helpful and are always available when they need assistance and six (6) staff members stated that residents are assisted throughout the day and that staff are assigned residents to care for while on shift, this ensures that someone is always available. LPA observed residents being assisted by the staff members throughout the facilities tour as well as the assignment book that shows which resident is assigned to the staff members.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Bernadette Allen	TELEPHONE: 951-897-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

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-20220311163213

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: ALLARA SENIOR LIVING	FACILITY NUMBER: 361881134
	VISIT DATE: 03/21/2023

NARRATIVE

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Allegation 2: Facility does not have a call system for resident to contact staff

LPA interviewed five (5) residents who said that they have a pendent that can push whenever they need help from the staff. LPA interviewed six (6) staff who all stated there is not a call system, but all residents have a pendent that they can push when help is needed. The six (6) staff members said when the pendent is pushed and staff are paged. The pager lets them know who needs help and where they are in the building. LPA observed residents in care wearing the pendent around their neck at the time of the visit with the exclusion of residents in memory.

Allegation 3: Resident was abandoned by staff during an emergency

Interviews were conducted with five (5) residents and six (6) staff members who said that to their knowledge they don’t recall any emergency that took place in 3/2022 where resident(s) were abandoned during an emergency. LPA observed one incident report for the month of 3/2022 which had nothing to do with an emergency.

Allegation 4: Staff denied resident visits

LPA interviewed five(5) residents who said that they have never been denied visitors during covid-19 and six(6) staff members were interviewed and they said that residents were never denied visitors but visitors who were not vaccinated were required to rapid test before visiting took place.

Based on the investigation interviews, documentation, and observations the above finding is Unsubstantiated. A finding of unsubstantiated means although the allegations 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, and a copy was provided to LeeAnne at the conclusion of the visit with the appeal rights.

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Bernadette Allen	TELEPHONE: 951-897-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

LIC9099 (FAS) - (06/04)

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