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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198204377
Report Date: 06/20/2024
Date Signed: 06/20/2024 11:45:36 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/18/2024 and conducted by Evaluator Cynthia D Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240618001037
FACILITY NAME:MOUNTAIN VIEW COTTAGES - IFACILITY NUMBER:
198204377
ADMINISTRATOR:PRISCO CASTILLOFACILITY TYPE:
740
ADDRESS:1147 CLEGHORN DR.TELEPHONE:
(909) 861-8508
CITY:DIAMOND BARSTATE: CAZIP CODE:
91765
CAPACITY:6CENSUS: 5DATE:
06/20/2024
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Jacqueline Runtukahu, StaffTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Staff did not provide a comfortable temperature for a resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cynthia Chan conducted a complaint investigation for the allegation listed above. LPA arrived unannounced and met with Staff, Jacqueline Runtukahu. The purpose for the visit was explained.

LPA obtained copies of the staff and resident rosters, toured the facility, and conducted interviews.

Allegation - Staff did not provide a comfortable temperature for a resident. It is alleged that the facility has no air conditioning and is intolerable. LPA interviewed the Administrator, Staff #1 - #2, and Residents #1 - #5. The administrator and staff acknowledged that the facility was quite warm earlier this week due to the air conditioner not working properly. Administrator stated she immediately contacted the maintenance personnel to fix the air conditioner when staff reported it not working on 6/13/24.
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
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 3
Control Number 28-AS-20240618001037
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: MOUNTAIN VIEW COTTAGES - I
FACILITY NUMBER: 198204377
VISIT DATE: 06/20/2024
NARRATIVE
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Administrator confirmed the facility was quite warm during her visit and provided fans for residents to use. Staff stated they turned on the air conditioner as the temperature became warmer on 6/13/24 and discovered it was not blowing out cool air. Staff indicated visitors also stated the facility was quite warm. According to AccuWeather, the temperature in the area was in the mid 80s during that week. Staff stated the air conditioner has been fixed as of 6/19/24. According to residents, some complain about feeling either hot or cold. When feeling cold, they add extra layers or use a blanket to stay warm. During the visit, LPA toured the facility and checked the thermostat. The air conditioner is working properly, and the facility is at a comfortable temperature.

Based on interviews conducted, the preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6 and Chapter 8), are being cited on the attached LIC 9099D.



An exit interview was conducted. A copy of this report and appeal rights were provided.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20240618001037
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: MOUNTAIN VIEW COTTAGES - I
FACILITY NUMBER: 198204377
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/20/2024
Section Cited
CCR
87303(a)
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87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
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The licensee shall ensure the air conditioner is in good repair at all times and submit proof of repair.

**The POC has been cleared as of today. LPA observed the air conditioner working.
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Based on interviews conducted, the licensee did not ensure the air conditioner is working properly which poses a potential health, safety, and personal rights to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3