366425270-5-8-2023-56-AS-NBRN-CRWNV5-20230517104721

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 366425270
Report Date: 05/08/2023
Date Signed: 05/08/2023 12:49:02 PM

Unsubstantiated

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
05/02/2023 and conducted by Evaluator Anna Bueno

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20230502113016

FACILITY NAME:	ABRIA DEL CIELO		FACILITY NUMBER:	366425270
ADMINISTRATOR:	CRISELDA ESPIRITU SANTO		FACILITY TYPE:	740
ADDRESS:	1589 N. WATERMAN AVE		TELEPHONE:	(909) 884-4757
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92404
CAPACITY:	240	CENSUS:	DATE:	05/08/2023
		UNANNOUNCED	TIME BEGAN:	08:53 AM
MET WITH:	Cris Espirirtu-Santo		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

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Staff handled resident in a rough manner.
Staff speaks inappropriately to resident.
Licensee does not ensure personnel records are maintained for each employee.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced visit to the facility to initiate the complaint investigation and deliver findings on the above allegations. LPA met with administrator Cris Espirirtu-Santo who was informed of the purpose of today’s visit. The investigation consisted of interviews with relevant parties, observations of the facility, and review of relevant records.

Allegation 1: Staff handled resident in a rough manner. Interview with resident state that staff did not take them by the arm roughly, and further stated that any physical contact is initiated only upon the resident’s request. During resident interviews, it was discovered that staff do not put their hands on residents nor have residents witnessed staff grab residents. Interviews with staff deny putting their hands on residents and reveal that no resident has reported being grabbed by staff. This allegation is unsubstantiated.

Allegation 2: Staff speaks inappropriately to resident. Resident interviewed deny that staff speak inappropriately to them. Interviews with residents revealed that staff are pretty good and do not speak inappropriately to

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Nedra Brown	TELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Anna Bueno	TELEPHONE: 951-204-4307
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2023

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-20230502113016

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: ABRIA DEL CIELO	FACILITY NUMBER: 366425270
	VISIT DATE: 05/08/2023

NARRATIVE

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residents. During staff interviews, it was disclosed that staff do not speak rudely to residents nor have residents reported being spoken to inappropriately or called names by any staff. This allegation is therefore unsubstantiated.

Allegation 3: Licensee does not ensure personnel records are maintained for each employee. LPA randomly reviewed five personnel records and found records to contain information as required in section 87412(a). LPA observed that the facility has a separate training book for in-service training, which do not always include subject covered by the training. This allegation is unsubstantiated and a technical assistance is being issued in relation to required staff training and orientation.

Based on information above, these allegations are unsubstantiated. A finding of 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.

An exit interview was conducted with Ms. Cris Espiritu-Santo and a copy of this report and LIC9102TA were provided.

SUPERVISOR'S NAME: Nedra Brown	TELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Anna Bueno	TELEPHONE: 951-204-4307
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2023

LIC9099 (FAS) - (06/04)

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