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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366425270
Report Date: 10/14/2024
Date Signed: 10/14/2024 04:12:45 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
10/10/2024 and conducted by Evaluator Renese Howell-Small
COMPLAINT CONTROL NUMBER: 56-AS-20241010124808
FACILITY NAME:ABRIA DEL CIELOFACILITY NUMBER:
366425270
ADMINISTRATOR:CRISELDA ESPIRITU SANTOFACILITY TYPE:
740
ADDRESS:1589 N. WATERMAN AVETELEPHONE:
(909) 884-4757
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY:240CENSUS: 134DATE:
10/14/2024
UNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Executive Director, Criselda Espiritu SantoTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Staff did not keep facility free of bed bugs.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Renese Howell-Small conducted an unannounced visit to the facility in order to investigate and/or deliver findings for the above allegations. LPA discussed the purpose of the visit with Executive Director, Criselda Espiritu Santo and this visit consisted of a facility tour, interviews, observation and record review.

LPA Howell-Small observed the temperature to be 73 degrees Fahrenheit, toured the two-story facility and visited seven (7) resident rooms. LPA obtained documentation of monthly extermination service, waterproof and anti-bed bug mattress covers and a Sleep Tight machine specifically used to eradicate bed bugs.

The allegation of staff did not keep facility free of bedbugs is UNSUBSTANTIATED.

UNSUBSTANTIATED is defined as, the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation did or did not occur.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Karen ClemonsTELEPHONE: (951) 836-2748
LICENSING EVALUATOR NAME: Renese Howell-SmallTELEPHONE: (951) 248-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2024
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-20241010124808
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: ABRIA DEL CIELO
FACILITY NUMBER: 366425270
VISIT DATE: 10/14/2024
NARRATIVE
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Based upon a tour of the facility, observation, record review and interviews with both staff and residents, all staff and resident denies witnessing bed bugs or being bitten by bed bugs. Licensing Program Analyst (LPA) Renese Howell-Small observed mattresses and bedding in resident bedrooms to be clean, in good condition and covered with waterproof and anti-bed bug mattress covers. Therefore, the allegation that staff did not keep facility free from bed bugs is UNSUBSTANTIATED.

In addition to regularly scheduled extermination, the staff follow House Rules in laundering donated clothing before the resident is allowed to place them in their rooms and are provided with containers with closed lids for opened food items to assist in maintaining a bug-free facility.

UNSUBSTANTIATED is defined as, the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation did or did not occur.


An exit interview was conducted and a copy of this report, LIC9099 and LIC9099C was provided to Executive Director, Criselda Espiritu Santo.
SUPERVISOR'S NAME: Karen ClemonsTELEPHONE: (951) 836-2748
LICENSING EVALUATOR NAME: Renese Howell-SmallTELEPHONE: (951) 248-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2