366425782-10-18-2021-18-AS-EMAN-CDNVEH-20220420162221

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 366425782
Report Date: 10/18/2021
Date Signed: 10/18/2021 12:41:13 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
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/13/2021 and conducted by Evaluator Stephanie Williams

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20211013105503

FACILITY NAME:	STEPPING STONE RESIDENTIAL CARE		FACILITY NUMBER:	366425782
ADMINISTRATOR:	GONZALES, CYNTHIA		FACILITY TYPE:	735
ADDRESS:	8502 CALABASH AVENUE		TELEPHONE:	(909) 355-4500
CITY:	FONTANA	STATE: CA	ZIP CODE:	92335
CAPACITY:	38	CENSUS: 34	DATE:	10/18/2021
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Channe Carlos		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff did not properly administer client's medication
Medications are accessible to client's in care
Staff yells at clients
Staff does not provide appropriate food service to clients

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Stephanie Williams made an unannounced visit to the facility in order to deliver findings for the above allegations. LPA identified herself and met with Administrator, Channe Carlos. LPA discussed the purpose of the visit with Carlos. The investigation consisted of records review, direct observation, and interviews with staff and clients.

In regards to allegation #1, LPA interviewed Client #1 (C1) who stated that on only once incidence, facility staff could not find C1's PRN medication when C1 had requested it. C1 also stated that they have not requested the PRN medication "for a while now." LPA interviewed Staff #1 (S1) who stated that all of C1's medications, including PRN medications, are located in the facility's medication room. LPA observed that several medications from C1's PRN medication bubble pack were popped out from the pack. S1 stated that C1's PRN medication has been administered to C1 several times as requested.

In regards to allegation #2, LPA observed that the medication room was locked and inaccessible upon arrival

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Stephanie Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2021

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 18-AS-20211013105503

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
RIVERSIDE, CA 92507

FACILITY NAME: STEPPING STONE RESIDENTIAL CARE	FACILITY NUMBER: 366425782
	VISIT DATE: 10/18/2021

NARRATIVE

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to the facility. LPA interviewed S1 who stated that the medication room is locked behind two doors at all times. LPA interviewed Client #2 (C2) and Client #3 (C3) who stated that they do not have access to their medications and that the medication room is locked at all times. LPA interviewed C1 who stated that they are unsure if the medication room is locked and inaccessible to clients in care.

In regards to allegation #3, LPA interviewed C1 who stated that staff members "can be" rude and sometimes yell at the clients. LPA interviewed C2 and C3 who denied that staff members are rude, yell at clients, or speak to clients innapropriately. LPA interviewed S1 and Staff #2 (S2) who denied that staff members are rude to clients, yell at clients, or speak to clients innapropriately.

In regards to allegation #4, LPA observed that the clients were being served lunch during time of visit. LPA observed that the clients were being served a sufficient portion of food, which included macaroni and cheese, bread, fruit, and juice. LPA also observed the facility's food supply, which appeared to be a sufficient supply for clients in care. LPA interviewed S1 and S2 who stated that the facility provides breakfast, lunch, dinner, and snack time. LPA interviewed C1 who stated that the facility does not provide snacks and will sometimes not provide C1 with food. LPA interviewed C2 and C3 who both stated that clients are served three meals a day plus snacks. C2 and C3 stated that they are provided with several beverages such as, juice, milk, and coffee.

Based on evidence obtained during today’s visit, LPA has determined that the above allegations are 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.

An exit interview was conducted where this report was discussed and a copy was provided to Carlos at the conclusion of the investigation.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Stephanie Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2021

LIC9099 (FAS) - (06/04)

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