361881134-11-5-2024-56-AS-NBRN-DHZPBX-20250626111104

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361881134
Report Date: 11/05/2024
Date Signed: 11/05/2024 06:35:55 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
10/29/2024 and conducted by Evaluator Lavette Farlow

COMPLAINT CONTROL NUMBER: 56-AS-20241029144831

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: 106	DATE:	11/05/2024
		UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Interim Administrator Ted Burgess		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Personal rights
Staff did not give medications according to physician's orders.

INVESTIGATION FINDINGS:

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Licensed Program Analysts (LPA) Lavette Farlow, conducted an unannounced visit to the facility to conduct a investigation. LPA was granted entrance into the facility by front desk staff. LPA identified self to staff. LPA was escorted to private dinning room where I was introduce to the Interim Administration Ted Burgess and discussed the purpose of the visit.

LPA conducted interviews with staff and residents, reviewed and obtained documents and did a walk-through of the facility.

First allegation, Personal rights. LPA conducted interviews with staff, LPA asked staff if resident's personal rights were being violated, all indicated that no resident's personal rights are being violated. LPA asked if anyone had observed staff yelling at residents in care, and not treating residents with dignity and respect, all denied witnessing other staff violate residents in care and not treating them with dignity and respect or yelling at residents. LPA asked if staff violated residents privacy rights by not knocking on residents in care door prior to entering their room or apartment or by not announcing themselves prior to entry in residents in care room or apartment, all denied witnessing staff violate residents privacy and stated we all knock and announce ourselves prior to entry. LPA conducted interviews with resident, LPA asked 9 residents if their personal rights were being violated, 8 out of 9 residents indicated that their personal rights are not being violated by staff. LPA asked resident if they have witnessed staff violate resident personal rights, 8 out of 9, stated that they have not witnessed staff violate other resident’s personal rights while in care. During the LPA's tour and investigation, LPA made several attempts to make contact with R1 by knocking on the door and ring doorbell, but R1 did not hear the doorbell due to R1 not having hearing aid in place. R1 instructed me to come closer so, R1 could hear me and asked that I give R1 a moment so R1 could put the hearing aid on.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2024

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-20241029144831

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: 11/05/2024

NARRATIVE

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Second allegation is Staff did not give medications according to physician's orders.
LPA conducted interviews with staff, LPA asked staff if residents are complaining about not receiving there medication or staff did not give medications according to physician's orders, all indicated that residents in care receive all scheduled medication. Although there is a chance that a resident might receive the medication 15-30 minutes before or after the scheduled time due to the medication rounds. LPA asked staff if they have witnessed other staff not give medications according to physician's orders, all stated that they have not witnessed other staff not administer medication according to the physician's orders. LPA conducted interviews with residents and asked clients if they are receiving their medication as schedule and according to physician's orders, and during my investigation if was found that some residents administer their own medication and the others stated they received the medication as schedule daily.

Based on the evidence obtained during the course of the investigation, LPA has determined that the above allegations are Unsubstantiated.

Unsubstantiated; meaning that 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 where this report (LIC 9099) was discussed, and a copy was provided Interim Administrator Ted Burgess at the end of the visit.

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2024

LIC9099 (FAS) - (06/04)

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