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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800237
Report Date: 11/13/2024
Date Signed: 11/13/2024 10:50:31 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO 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
09/23/2024 and conducted by Evaluator Raquel Hernandez
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240923121302
FACILITY NAME:GABRIELA CARE HOME INCFACILITY NUMBER:
331800237
ADMINISTRATOR:CALILUNG, RESTITUTOFACILITY TYPE:
740
ADDRESS:1717 TAMARRON DRIVETELEPHONE:
(714) 906-6046
CITY:CORONASTATE: CAZIP CODE:
92883
CAPACITY:6CENSUS: 5DATE:
11/13/2024
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Administrator Bene MolinitasTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff did not safeguard resident's personal items
Staff made inappropriate comments towards resident
Staff does not treat resident with dignity and respect
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Raquel Hernandez conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Administrator Bene Molinitas and explained the purpose of the visit. The investigation consisted of staff interviews, resident interviews and facility tour.

For the allegation, Staff did not safeguard resident's personal items.

LPA Hernandez conducted five (5) resident interviews and three (3) staff interviews. During resident interviews 5 out of the 5 residents stated the facility does safeguard and keep their personal belongings safe. During the staff interviews 3 out of the 3 staff stated they ensure resident's personal belongings are safe by allowing residents to keep belongings with them or in their room cabinet.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2024
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 56-AS-20240923121302
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: GABRIELA CARE HOME INC
FACILITY NUMBER: 331800237
VISIT DATE: 11/13/2024
NARRATIVE
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For the allegation, Staff made inappropriate comments towards resident.

LPA Hernandez conducted five (5) resident interviews and three (3) staff interviews. During resident interviews 5 out of the 5 residents stated staff do not speak inappropriate with them. During staff interviews 3 out of the 3 staff stated they do not make inappropriate comments towards any of the residents at the facility.
For the allegation, Staff does not treat resident with dignity and respect.

LPA Hernandez conducted five (5) resident interviews and three (3) staff interviews. During resident interviews 5 out of the 5 residents stated staff does treat them with dignity and respect. During staff interviews 3 out of the 3 staff stated they treat all their residents at the facility with dignity and respect.


Based on the evidence gathered during today’s investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC9099) was discussed and provided to Administrator Bene Molinitas.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2