361881134-3-21-2023-56-AS-KCLS-CQSU28-20230411151132

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361881134
Report Date: 03/21/2023
Date Signed: 03/21/2023 01:26:57 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
04/06/2022 and conducted by Evaluator Bernadette Allen

COMPLAINT CONTROL NUMBER: 56-AS-20220406094430

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:	12:00 PM
MET WITH:	LeeAnn Hefner Administrator		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Staff caused injury to resident(s).
Resident's medication was not administered
Staff did not respond to resident's calls for help
Staff interrupted resident’s sleep.
Facility fruit is rotten.

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 caused injury to resident(s).
LPA attempted to interview the resident in question. Resident 1 (R1) no longer lives at the facility and LPA attempted to interview two (2) residents who were not oriented enough to confirm or deny if staff has ever caused injury to them while in care. R1's file was revevied and there was documentation that show the resident did have an injury that was being accessed by an outside healthcare provider on a regular basis.

Allegation 2: Resident's medication was not administered
LPA reviewed Resident 1 (R1) files which shows that the resident was given their medication as prescribed by the physician’s orders.

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-20220406094430

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 3: Staff did not respond to resident's calls for help
Interviews were conducted with six (6) staff members who said that residents are always responded to when help is needed and residents that are in their memory care unit are never left alone because of their level of care. During the visit LPA observed residents in care being assisted by the staff.

Allegation 4: Staff interrupted resident’s sleep
LPA attempted to interview two (2) residents who could not confirm or deny that staff interrupts their sleep because of not being oriented. Resident 1 (R1) The resident in question could not be interviewed because they no longer live at the facility. The six (6) interviews with the staff said that residents are never forced to be assisted with continence needs they are asked first before assistance is provided.

Allegation 5: Facility fruit is rotten
LPA toured the facility including the kitchen, and LPA observed that there was fresh fruit being provided to the residents and six (6) staff members were interviewed who said that there has never been a time when rotten fruit was given to residents. The five (5) interviews conducted with the residents who deny that rotten fruit was provided to them.

Based on the investigation interviews, documentation, and observations the above findings are 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 Hefner 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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