366425270-12-11-2024-56-AS-EMAN-DC3VXL-20241218154940

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 366425270
Report Date: 12/11/2024
Date Signed: 12/11/2024 02:45:41 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
08/14/2024 and conducted by Evaluator Melody Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240814082855

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: 148	DATE:	12/11/2024
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Executive Director Criselda Espiritu Santo		TIME COMPLETED:	02:50 PM

ALLEGATION(S):

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Staff do not ensure residents are not eating expired/moldy food.

INVESTIGATION FINDINGS:

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On 12/11/2024 at 10:00 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 and granted entrance by a staff. Executive Director (ED) Criselda Espiritu Santo was contacted and informed of the visit and LPA Brown explained the purpose of the visit to ED Espiritu Santo.

The investigation was conducted by LPA Brown. The investigation consisted of file review, observations and interviews with relevant parties. The allegation indicates Staff do not ensure residents are not eating expired/moldy food. During the investigation, LPA Brown did not find evidence to corroborate the allegation. Interview with ten (10) of ten (10) residents indicated that staffs at the facility are ensuring that the food they are serving them are fresh and no incident happened that staff gave them expired or moldy food. During the facility visit on 08/15/2024, Resident #1 (R1) reported to LPAs Melody Brown and Raquel Hernandez that the food served to R1 was not moldy but the chicken served has no meat on it and it did not taste good. During the facility visit today, 12/11/2024, R1 informed LPA Brown that staffs at the facility ***Cont. in LIC9099C***

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Melody Brown	TELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024

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-20240814082855

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: 12/11/2024

NARRATIVE

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are always serving fresh food and added that R1 never had an expired or moldy food. Interviews with seven (7) of seven staffs indicated that they are all ensuring that residents are not eating expired/moldy food. Seven (7) of seven staff interviews revealed that there's no incident that happened at the facility that they did not ensure that residents are not eating expired or moldy food because most of them eat the facility food after serving their residents. During the facility visit on 09/16/2024, LPAs Brown and Renese Howell-Small observed that the facility does not have expired foods in their perishable and non-perishable food supplies. During the facility visit today, 12/11/2024, LPA Brown checked the perishable and non-perishable food supplies and no expired or moldy food observed. Also, LPA Brown noted that no expired or moldy food served to the residents for lunch. Moreover, ED Espiritu Santo provided the facility menu to LPA Brown on 12/11/2024.

Based on interviews, records review and observation, the allegation Staff do not ensure residents are not eating expired/moldy food is UNSUBSTANTIATED. A finding of unsubstantiated means 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.

An exit interview was conducted, where this report (LIC9099) was discussed and provided to ED Criselda Espiritu Santo.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Melody Brown	TELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024

LIC9099 (FAS) - (06/04)

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