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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 366426866
Report Date: 08/01/2022
Date Signed: 08/01/2022 11:47:40 AM

Document Has Been Signed on 08/01/2022 11:47 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME:HELPING HEARTS VISCONTIFACILITY NUMBER:
366426866
ADMINISTRATOR:MANUAL SOTOFACILITY TYPE:
772
ADDRESS:1288 VISCONTI DRIVETELEPHONE:
(909) 260-8515
CITY:COLTONSTATE: CAZIP CODE:
92324
CAPACITY: 10CENSUS: 10DATE:
08/01/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:57 AM
MET WITH:Brian WhitworthTIME COMPLETED:
11:49 AM
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Licensing Program Analyst (LPA) Anna Bueno made an unannounced visit to the facility for the purpose of conducting a case management visit related to several incident reports related to clients missing medications.

The Department received several incident reports between 5/24/2022 through 7/4/2022 of clients missing medication. LPA reviewed July 2022 MARS for 5 of 10 clients. LPA conducted staff interviews related to medication administration. LPA found that an in-service training for reducing medication errors was conducted in the facility on 7/14/22. Medications are audited twice a week and supply is ordered 7-10 days before tehy run out. The facility also has medication disposal scheduled once a month.

No deficiency was cited during today's visit. An exit interview was conducted where a copy of this report was discussed and provided to administrator at the conclusion of today's visit.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Anna Bueno
LICENSING EVALUATOR SIGNATURE: DATE: 08/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/01/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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