366425834-8-5-2024-56-AS-KCLS-D8472A-20240812211621

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 366425834
Report Date: 08/05/2024
Date Signed: 08/05/2024 11:28:59 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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
06/26/2024 and conducted by Evaluator Magda Malcore

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240626091305

FACILITY NAME:	FOREMOST SENIOR CAMPUS		FACILITY NUMBER:	366425834
ADMINISTRATOR:	NIRUPAMA VANGALA		FACILITY TYPE:	740
ADDRESS:	17581 SULTANA STREET		TELEPHONE:	(760) 244-5579
CITY:	HESPERIA	STATE: CA	ZIP CODE:	92345
CAPACITY:	96	CENSUS: 78	DATE:	08/05/2024
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Danica Turner		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff engaging in inappropriate interactions with a resident in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced visit to conclude the complaint investigation on the above allegation. LPA met with Administrator, Danica Turner, who was informed of today’s visit.

Regarding the allegation, staff engaging in inappropriate interactions with a resident in care, interviews with the Administrator, four (4) staff, and five (5) residents reveal not enough evidence to corroborate the allegation.

Based on resident and staff interviews, the allegation is Unsubstantiated. A finding of Unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted where this report was discussed and provided with appeal rights to the Administrator at the conclusion of the visit.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Magda Malcore	TELEPHONE: 951-248-0316
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2024

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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