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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366412343
Report Date: 11/07/2024
Date Signed: 11/07/2024 05:03:08 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
11/05/2024 and conducted by Evaluator Lavette Farlow
COMPLAINT CONTROL NUMBER: 56-AS-20241105091438
FACILITY NAME:RL HOME CARE IIFACILITY NUMBER:
366412343
ADMINISTRATOR:ROBERT LANDICHOFACILITY TYPE:
735
ADDRESS:1431 N. ASH AVE.TELEPHONE:
(909) 421-1094
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY:6CENSUS: 2DATE:
11/07/2024
UNANNOUNCEDTIME BEGAN:
03:35 PM
MET WITH:Robert Landicho, LicenseeTIME COMPLETED:
05:07 PM
ALLEGATION(S):
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Staff hit resident
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) LaVette Farlow and Magda Malcore conducted an unannounced visit to the facility to investigate the above allegation. LPAs were granted entrance into the home by Mark Munoz, Direct Care Staff. LPAs asked Mark to notify Licensee Robert Landicho, of our arrival. Licensee Robert Landicho later arrived and was informed of the purpose of the visit. The investigation consisted of LPAs record review, interviews with staff and residents.

Regarding the allegation, staff hit resident, LPAs interviewed two (2) staff and two (2) residents. Staff interviews reveal they have never hit a resident, nor witnessed other staff hit a resident. Two (2) out of two (2) resident interviews reveal staff have not hit them, nor witnessed other staff hit a resident.

Based on evidence obtained during this investigation, the allegation above 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.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
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-20241105091438
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: RL HOME CARE II
FACILITY NUMBER: 366412343
VISIT DATE: 11/07/2024
NARRATIVE
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An exit interview was conducted where this report was discussed. A copy of this report was provided with appeal rights to Licensee, Robert Landicho at the conclusion of the visit.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2