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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366400113
Report Date: 08/26/2024
Date Signed: 08/26/2024 11:33:44 AM

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
05/27/2024 and conducted by Evaluator Paola Guerrero
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240527231546
FACILITY NAME:GARDENFACILITY NUMBER:
366400113
ADMINISTRATOR:MICHAEL BRLETICHFACILITY TYPE:
735
ADDRESS:9212 GARDEN STREETTELEPHONE:
(909) 941-4449
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91701
CAPACITY:6CENSUS: 4DATE:
08/26/2024
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Latasha Love- House ManagerTIME COMPLETED:
11:40 AM
ALLEGATION(S):
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Staff did not ensure a client's medication was properly stored
Staff are mishandling a client's personal funds
Staff are not following proper food handling techniques
Staff failed to keep facility clean
Staff did not post a food menu for the clients
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Facility House Manager Latasha Love and explained the purpose of the visit. The investigation consisted of interviews and review of records.

First allegation, Staff did not ensure a client's medication was properly stored. LPA conducted an interview with Staff#1 pertaining to the allegation stated above Staff #1 indicated to LPA that Client #1 was recently admitted to their facility. Staff#1 stated that during client’s admission staff took record of all Client #1 belongings and found no medication on client#1 belongings. LPA conducted an interview with Client#1 who stated to LPA of not being or currently taking any medication. Client#1 stated that upon admission client had forgotten about medication that was left inside clients’ belongings and forgot to report medication to facility staff. Client#1 stated to LPA that medication was given to Inland Regional Center CRC worker and facility staff during 30-day intake meeting, when CRC worker mentioned to Client#1 about medication. Client#1 stated to LPA that client has been off medication for a while and was not taking any medication and that is why client forgot to give medication to staff upon admission.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Paola GuerreroTELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2024
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-20240527231546
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: GARDEN
FACILITY NUMBER: 366400113
VISIT DATE: 08/26/2024
NARRATIVE
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Second allegation, Staff are mishandling a client's personal funds. LPA conducted a file review on Client #1 LPA observed a blank PNI ledger pertaining to Client #1 on file. LPA conducted an interview with Staff#1 pertaining to clients blank PNI ledger. Staff #1 explained to LPA that client had been admitted to facility about a month ago and stated that IRC Worker is working on switching Client#1 from being their own payee to providing Client#1 with their own B&R/Payee. LPA conducted an interview with Inland Regional CRC who stated that B&R/Payee has yet to be appointed to client. Client #1 indicated to LPA that client has always managed their own funds prior to being admitted and is now waiting for IRC, to appoint client with their own payee.

Third allegation, Staff are not following proper food handling techniques. LPA conducted an inspection of facilities kitchen pertaining to the allegation stated above. During the inspection LPA observed sufficient food in the pantry LPA observed that the food in the pantry was shelf-stable and safe for clients to eat. During the inspection LPA observed sufficient food to be in the refrigerator/and freezer, all food appeared to be shelf stable and safe for clients to eat. LPA observed appliances to be in good and working conditions and temperatures were based on title 22 regulations.

Fourth allegation, Staff failed to keep facility clean. LPA conducted an inspection of the facility based on the allegation stated above. During the inspection Staff #1 accompanied LPA with a walkthrough of the facility. During the inspection LPA observed facility to be clean and clear of any obstruction. LPA inspected client’s bedrooms, during inspection LPA observed that one room needed some cleaning. During interview with clients all clients stated that every client is responsible of their own room along with the maintaining of the room. LPA conducted interviews with staff and all staff stated that cleaning is encouraged however, not forced due to the violation of the client’s personal rights.

Fifth allegation, Staff did not post a food menu for the clients. LPA conducted an inspection of the facilities kitchen based on the allegation stated above. During the inspection Staff #1 accompanied LPA and appointed LPA to facilities food menu LPA observed facilities food menu to be located on the side of the refrigerator Staff#1 stated to LPA that food menu gets updated every Sunday. Based on corroborating 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 to Facility House Manager Latasha Love at the end of the visit.
SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Paola GuerreroTELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2