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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800168
Report Date: 03/06/2024
Date Signed: 03/06/2024 11:45:42 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 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
02/29/2024 and conducted by Evaluator Crystal Colvin
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240229133536
FACILITY NAME:DULCE VILLA IIFACILITY NUMBER:
331800168
ADMINISTRATOR:MODY, NIKULFACILITY TYPE:
740
ADDRESS:66171 S AGUA DULCE DRTELEPHONE:
(760) 251-4606
CITY:DESERT HOT SPRINGSSTATE: ZIP CODE:
92240
CAPACITY:6CENSUS: 4DATE:
03/06/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH: Lorena Guillan - Facility ManagerTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Facility has a bed bug infestation
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility unannounced in order to initiate an investigation of a complaint with the above allegation(s). LPA identified herself and discussed the purpose of the visit and the elements of the allegation(s) with Facility Manager Lorena Guillan. Below is a summary of the complaint investigation findings:

Regarding allegation "Facility has a bed bug infestation": LPA Colvin conducted interviews with staff and resident(s) and toured the facility during today's inspection. Interviews conducted confirm that there was an issue with bed bugs in one resident room (R1), but that the facility has taken steps to elimiate the problem. Some of the steps taken include: replacing all of the furniture in R1's room, deep cleaning R1's room and other resident bedrooms, and treating R1's room with bed bug spray as well as pesticide "bombs". LPA Colvin inspected R1's bedroom and other resident bedrooms and did not observe any evidence of bed bugs currently at this location.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024
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 2
Control Number 18-AS-20240229133536
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: DULCE VILLA II
FACILITY NUMBER: 331800168
VISIT DATE: 03/06/2024
NARRATIVE
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Due to lack of evidence of the bed bugs being an ongoing issue and facility staff taking measures to rectify the problem once it was brought to their attention, the allegation of "Facility has a bed bug infestation" is UNSUBSTANTIATED.

A finding of UNSUBSTANTIATED means 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 with Facility Manager Lorena Guillan and Administrator Trupti Mody (via telephone) and a copy of this report was provided.
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2