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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361800139
Report Date: 09/27/2023
Date Signed: 10/02/2023 09:23:10 AM

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
09/05/2023 and conducted by Evaluator Bernadette Allen
COMPLAINT CONTROL NUMBER: 56-AS-20230905164952
FACILITY NAME:HELPING HEARTS KERNFACILITY NUMBER:
361800139
ADMINISTRATOR:SMITH, MELLISAFACILITY TYPE:
772
ADDRESS:2421 KERN STREETTELEPHONE:
(909) 260-8061
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92407
CAPACITY:10CENSUS: DATE:
09/27/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Julie Wander- Program DirectorTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Staff does not provide residents’ medication(s) as prescribed.
Staff did not provide adequate supervision resulting in resident eloping from the facility.
Staff did not prevent residents from engaging in physical altercation while in the facility.
Staff did not communicate with residents' authorized representative.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to deliver findings for the mentioned allegations. LPA Allen met with Julie Wander- Program Director who was informed of the purpose of the visit.

The investigation consisted of file review, interviews with outside parties, staff members and client1(C1).
C1’s file/records were reviewed, and records confirmed that C1 was given their medication as prescribed by their physician. Records also revealed that there was sufficient staffing at the time C1 eloped from the facility. The interviews with the staff members and clients all deny that there have been any altercations among clients and there were no witnesses to corroborate the allegation or evidence of clients being in a physical altercation. The interview with outside parties has also stated there was no reporting of physical altercations among clients.The interviews conducted and records reviewed revealed that facility staff did communicate with C1's authorized representative thoughout C1's unauthorized leave from the facility.
Based on file review and interviews with the staff, clients, and outside parties the allegations findings are Unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Karen ClemonsTELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Bernadette AllenTELEPHONE: 951-897-2618
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 56-AS-20230905164952
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: HELPING HEARTS KERN
FACILITY NUMBER: 361800139
VISIT DATE: 09/27/2023
NARRATIVE
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 A finding of unsubstantiated means although the allegations 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, and this report was discussed and provided to Julie Wander- Program Director at the conclusion of the visit.
SUPERVISOR'S NAME: Karen ClemonsTELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Bernadette AllenTELEPHONE: 951-897-2618
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2