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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366424637
Report Date: 03/06/2025
Date Signed: 03/06/2025 03:42:20 PM

Substantiated


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
11/26/2024 and conducted by Evaluator Renese Howell-Small
COMPLAINT CONTROL NUMBER: 56-AS-20241126101245
FACILITY NAME:NEW DISCOVERY RESIDENTIAL SERVICES IFACILITY NUMBER:
366424637
ADMINISTRATOR:VIVIAN FRANCISCOFACILITY TYPE:
735
ADDRESS:26278 DATE STREETTELEPHONE:
(909) 280-9644
CITY:HIGHLANDSTATE: CAZIP CODE:
92346
CAPACITY:6CENSUS: 3DATE:
03/06/2025
UNANNOUNCEDTIME BEGAN:
02:37 PM
MET WITH:Zorina FranciscoTIME COMPLETED:
03:10 PM
ALLEGATION(S):
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Inappropriate interactions between clients due to lack of supervision
INVESTIGATION FINDINGS:
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Licensing Program Analyst, Renese Howell-Small, (LPA) arrived at New Discovery Residential Services I unannounced to deliver findings for the complaint investigation into the allegations listed above. LPA met with staff Zorina Francisco, introduced self and stated purpose of the visit.

The investigation was based upon observation, interviews and record review.

The allegation alleged that there was Inappropriate interactions between clients due to lack of supervision. LPA interviewed three (3) staff and one (1) resident whom stated that Resident 1 (R1) does express behaviors of hitting other residents, knocking on resident room doors and sitting in front of the bathroom door while it is in use by another resident. In addtion, an interview conducted with staff at the Inland Regional Center (IRC) stated that due to the behaviors of R1, there is a need for one-on-one staff for R1. Therefore, this allegation is SUBSTANTIATED. A deficiency will be cited.

A SUBSTANTIATED complaint is defined as a violation has occurred and the preponderance of evidence has been met. An exit interview was conducted where a copy of this report LIC9099, LIC9099D and appeal rights were provided to staff Zorina Francisco.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
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-20241126101245
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: NEW DISCOVERY RESIDENTIAL SERVICES I
FACILITY NUMBER: 366424637
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/07/2025
Section Cited
CCR
85065(b)
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85065 Personnel Requirements
(b) The licensee shall employ staff as necessary to ensure provision of care and supervision to meet client needs.

This requirement is not met as evidenced by:
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Licensee/Administrator will schedule an additional staff when all three (3) residents are at the facility and will provide Licensing Program Analyst (LPA) with the staff schedule by the Plan of Correction due date.
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Based upon observation, interview and record review, Licensee/Administrator did not ensure that facility had and additional staff to supervise Resident 1 (R1) which posed, an immediate risk to the health, safety and personal rights of residents 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: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
LIC9099 (FAS) - (06/04)
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