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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366410618
Report Date: 09/30/2024
Date Signed: 09/30/2024 10:25:48 AM

Substantiated


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
05/21/2024 and conducted by Evaluator Melody Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240521145142
FACILITY NAME:OHIO LANE MANORFACILITY NUMBER:
366410618
ADMINISTRATOR:HANNER, CYNTHIAFACILITY TYPE:
735
ADDRESS:7122 OHIO LANETELEPHONE:
(909) 823-7122
CITY:FONTANASTATE: CAZIP CODE:
92336
CAPACITY:4CENSUS: 3DATE:
09/30/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator Kristin Mcgee RidingsTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Staff not providing safe and comfortable accommodation to clients' in care.
INVESTIGATION FINDINGS:
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On 09/30/2024 at 09:30 AM, Licensing Program Analyst (LPA) Melody Brown conducted an unannounced visit to the facility to deliver the findings of the above allegation. LPA Brown was greeted by Administrator Kristin Mcgee Ridings family member and LPA Brown met with Administrator Kristin Mcgee Ridings. LPA Brown identified self and discussed the purpose of the visit and the elements of the allegation with Administrator Kristin Mcgee Ridings.

The investigation was conducted by LPAs Melody Brown and Sarina Ramirez. The investigation consisted of observation and interviews with relevant parties. The allegation indicates that staff not providing safe and comfortable accomodation to clients' in care. During the investigation, LPAs Brown and Ramirez obtained evidence to corroborate the allegation. Staff #1 (S1) confirmed with LPA Brown arguing with Tenant #1 (T1) late at night on 05/20/2024 and S1 added that they are aware that Client #1 (C1) was awake that time and that C1 heard their argument. In addition, S1 informed LPA Brown that S1 apologized to C1 for hearing their late night argument that resulted to C1's lack of sleep. ***Continuation in LIC9099C***
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024
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 5
Control Number 56-AS-20240521145142
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: OHIO LANE MANOR
FACILITY NUMBER: 366410618
VISIT DATE: 09/30/2024
NARRATIVE
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Moreover, on 05/22/2024, LPA Sarina Ramirez interviewed C1 and C1 confirmed that on 05/20/2024, C1 heard S1 and T1 arguing late at night that prevented C1 from sleeping. Based on observation and interviews, the allegation of staff not providing safe and comfortable accommodation to clients' in care 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.

An exit interview was conducted and a copy of this report, LIC9099, LIC9099D and Appeal Rights was discussed and provided to Administrator Kristin Mcgee Ridings.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 56-AS-20240521145142
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: OHIO LANE MANOR
FACILITY NUMBER: 366410618
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/30/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/07/2024
Section Cited
CCR
80072(a)(2)
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80072 Personal Rights (a) Except for children’s residential facilities, each client shall have personal rights which include... (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement is not met as evidenced by:
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Licensee stated to train all staff on CCR 80072(a)(2) and submit proof of staff training log to LPA Brown on Plan of Correction (POC) due date.
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Based on observation and interview, the Licensee did not comply with the section cited above by not ensuring that Client #1 (C1) was provided safe and comfortable accomodation as evidenced of S1 and T1 arguing late at night on 05/20/2024 that resulted to C1's lack of sleep which poses a potential health, safety and personal rights risk to client 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.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
05/21/2024 and conducted by Evaluator Melody Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240521145142

FACILITY NAME:OHIO LANE MANORFACILITY NUMBER:
366410618
ADMINISTRATOR:HANNER, CYNTHIAFACILITY TYPE:
735
ADDRESS:7122 OHIO LANETELEPHONE:
(909) 823-7122
CITY:FONTANASTATE: CAZIP CODE:
92336
CAPACITY:4CENSUS: 3DATE:
09/30/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator Kristin Mcgee RidingsTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Staff does not treat client with dignity and respect.
INVESTIGATION FINDINGS:
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On 09/30/2024 at 09:30 AM, Licensing Program Analyst (LPA) Melody Brown conducted an unannounced visit to the facility to deliver the findings of the above allegation. LPA Brown was greeted by Administrator Kristin Mcgee Ridings family member and LPA Brown met with Administrator Kristin Mcgee Ridings. LPA Brown identified self and discussed the purpose of the visit and the elements of the allegation with Administrator Kristin Mcgee Ridings.

The investigation was conducted by LPAs Melody Brown and Sarina Ramirez. The investigation consisted of observation and interviews with relevant parties. The allegation indicates that staff does not treat client with dignity and respect. During the investigation, LPAs Brown and Ramirez did not find evidence to corroborate the allegation. Interviews with two (2) of two (2) staff indicated that they are treating their clients with dignity and respect. Interviews with two (2) of two (2) staffs revealed that no incident happened at the facility that a staff did not treat Client #1 (C1) with dignity and respect. Moreover, Staff #1 (S1) indicated that they did not say that C1's "incompetent," and S1 added that they would never do that. ***Continuation in LIC9099C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 56-AS-20240521145142
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: OHIO LANE MANOR
FACILITY NUMBER: 366410618
VISIT DATE: 09/30/2024
NARRATIVE
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In addition, LPA Brown contacted C1 Inland Regional Center (IRC) Consumer Services Coordinator (CSC) and C1 IRC CSC provided information to LPA Brown that during their in-person meeting on 05/29/2024, C1 admitted to them that S1 did not call C1 "incompetent." Furthermore, IRC CSC indicated that during their meeting, they observed and concluded that C1's switching words depending on how C1 feels. IRC CSC reported that during their meeting, they observed that C1's experiencing increased behavior due to stress from C1's job. Also, C1 IRC CSC shared that during their meeting, C1 apologized to S1 and C1's job coach for C1's untrue statement. Lastly, IRC CSC reported to LPA Brown that they believed that S1's treating C1 with dignity and respect as C1 requested to stay at the facility.

Based on the evidence, the allegation that staff does not treat client with dignity and respect is UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means 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, therefore the allegation is unsubstantiated at this time.

An exit interview was conducted where this report, LIC9099 was discussed and provided to Administrator Kristin Mcgee Ridings
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5