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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366404072
Report Date: 10/30/2023
Date Signed: 10/30/2023 01:22:55 PM

Substantiated


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
10/25/2023 and conducted by Evaluator Magda Malcore
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20231025084736
FACILITY NAME:DESERT ROSE ELDER CAREFACILITY NUMBER:
366404072
ADMINISTRATOR:MCGILL-CUNAGIN, SHARONFACILITY TYPE:
740
ADDRESS:73511 SUNNYVALE DR.TELEPHONE:
(760) 367-9175
CITY:TWENTYNINE PALMSSTATE: CAZIP CODE:
92277
CAPACITY:20CENSUS: 16DATE:
10/30/2023
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Sharon Mcgill-CunaginTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Facility administered wrong medication to resident in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced complaint visit to the facility. LPA Malcore met with Administrator, Sharon Mcgill-Cunagin, and discussed the purpose of the visit.
Regarding the allegation, Facility administered wrong medication to resident in care, staff #1(S1) took another resident's medication and gave it to resident #1 (R1) in error.
Based on document review and interviews with relevant parties, the above allegation is SUBSTANTIATED. A finding that the complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.
A plan of correction was discussed with Administrator, Mcgill-Cunagin. An exit interview was conducted at the conclusion of the visit and a copies of reports(LIC9099/LIC9099-D) with appeal rights was provided to the Administrator at the conclusion of the visit.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Karen ClemonsTELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Magda MalcoreTELEPHONE: 951-248-0316
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023
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 3
Control Number 56-AS-20231025084736
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: DESERT ROSE ELDER CARE
FACILITY NUMBER: 366404072
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/30/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/03/2023
Section Cited
CCR
87465(c)(2)
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87465(c)…facility staff designated by the licensee shall be permitted to assist the resident with self-administration… (2) Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by:
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Licensee/Administrator shall re-train staff on medication management. Proof of training shall be submitted to the Licensing Agency by POC due date.
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staff #1(S1) took another resident's medication and gave it to resident #1 (R1) in error, which poses an immediate health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Karen ClemonsTELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Magda MalcoreTELEPHONE: 951-248-0316
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
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
10/25/2023 and conducted by Evaluator Magda Malcore
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20231025084736

FACILITY NAME:DESERT ROSE ELDER CAREFACILITY NUMBER:
366404072
ADMINISTRATOR:MCGILL-CUNAGIN, SHARONFACILITY TYPE:
740
ADDRESS:73511 SUNNYVALE DR.TELEPHONE:
(760) 367-9175
CITY:TWENTYNINE PALMSSTATE: CAZIP CODE:
92277
CAPACITY:20CENSUS: 16DATE:
10/30/2023
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Sharon Mcgill-CunaginTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Facility did not seek timely medical care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced complaint visit to the facility. LPA Malcore met with Administrator, Sharon Mcgill-Cunagin, and discussed the purpose of the visit.
Regarding the allegation, facility did not seek timely medical care, Staff interviews reveal that while resident #1's (R1) physical therapist was visiting, the physical therapist found R1 unresponsive. The physical therapist came out of R1's room and told staff to call 911. Staff immediately called 911 and emergency services arrived shortly after. Resident's family and the Administrator were notified of the incident.
Based on document review and interviews, the allegation is 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 was discussed, and a copy with appeal rights was provided to the Administrator at the conclusion of the visit.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Karen ClemonsTELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Magda MalcoreTELEPHONE: 951-248-0316
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3