366405765-5-23-2024-56-AS-EMAN-DGXPPW-20250523113014

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 366405765
Report Date: 05/23/2024
Date Signed: 05/23/2024 01:23:34 PM

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
01/11/2024 and conducted by Evaluator Mary Rico

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240111085656

FACILITY NAME:	CASA COLINA CENTERS FOR REHABILITATION/PADUA VILLA		FACILITY NUMBER:	366405765
ADMINISTRATOR:	RODNEY PEEK		FACILITY TYPE:	735
ADDRESS:	22200 HIGHWAY 18		TELEPHONE:	(760) 247-7711
CITY:	APPLE VALLEY	STATE: CA	ZIP CODE:	92307
CAPACITY:	54	CENSUS: 36	DATE:	05/23/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Stephanie Kaplan and Maria Pinto		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff are not seeking medical attention for resident in care in a timely manner.
Facility is retaining a resident who has a higher level of care needs.
Licensee is not prominently posting complaint information in areas accessible to residents, representatives, and the public.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Administrator Stephanie Kaplan and Residential Manager Maria Pinto and explained the purpose of the visit. The investigation consisted of staff interviews, client interviews and record review.

For the allegation, Staff are not seeking medical attention for resident in care in a timely manner.

LPA Rico conducted seven (7) staff interviews. 7 out of the 7 staff stated their residents received medical attention in a timely manner. 4 out of the 7 staff informed they will notify management if they notice any changes in their clients.

LPA Rico conducted five (5) client interview. 4 out of the 5 clients stated they received medical attention in a timely manner. 1 out of the 5 stated they are independent and do not require medical attention.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2024

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-20240111085656

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: CASA COLINA CENTERS FOR REHABILITATION/PADUA VILLA	FACILITY NUMBER: 366405765
	VISIT DATE: 05/23/2024

NARRATIVE

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For the allegation, Facility is retaining a resident who has a higher level of care needs.

During staff interviews, 6 out of the 7 staff informed LPA they do not know if the facility is retaining a resident who has a higher level of care. 1 out of the 7 staff stated C1 has been declining and are in the process of relocating client.

For the allegation, Licensee is not prominently posting complaint information in areas accessible to residents, representatives, and the public.

During facility tour, LPA observed complaint posting in the common area accessible to clients and representatives.

During staff interviews, 7 out of the 7 staff informed LPA the complaint posters are in located in the break room and dining room area. 5 out of the 7 staff stated that clients will remove posters when they have behaviors.

Based on the evidence found during the investigation, the three (3) allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report was discussed and provided to Residential Manager Maria Pinto, along with a copy of the appeal rights.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2024

LIC9099 (FAS) - (06/04)

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