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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881480
Report Date: 07/17/2024
Date Signed: 07/17/2024 12:59:02 PM

Unfounded


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
07/16/2024 and conducted by Evaluator Javina George
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240716141532
FACILITY NAME:ARLINGTON RIVERSIDE SENIOR COMMUNITYFACILITY NUMBER:
331881480
ADMINISTRATOR:WILLIAMS, MORGANFACILITY TYPE:
740
ADDRESS:4609 ARLINGTON AVETELEPHONE:
(951) 462-1025
CITY:RIVERSIDESTATE: CAZIP CODE:
92504
CAPACITY:232CENSUS: 84DATE:
07/17/2024
UNANNOUNCEDTIME BEGAN:
11:06 AM
MET WITH:Molly Bowie, Executive DirectorTIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Licensee is not properly addressing pest issue in the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to commence a complaint investigation in regards to the allegation noted above. LPA met with Executive Director Molly Bowie and explained the purpose of the visit and the elements of the allegation.

On 7/16/24 Community Care Licensing received a complaint alleging the licensee is not properly addressing the pest issue in the facility, specifically rats, termites and cockroaches. LPA conducted a review of a special service agreement from the local exterminator company, which revealed that the licensee entered into a contract with the local exterminator company on or around 10/16/23. The service agreement lists the following pest coverage: (rats, mice, cockroaches, rolly pollies, crickets, common ants, pincher bugs). LPA reviewed a recent service contract dated 7/13/24 that notes that bed bug inspection and treatment was performed in a resident bedroom. Per interview with Executive Director Molly Bowie, the room that was treated had the following items discarded and replaced (mattress and box spring), all the clothing and bedding was removed and washed. The resident was relocated to another room while room their room is
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024
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-20240716141532
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: ARLINGTON RIVERSIDE SENIOR COMMUNITY
FACILITY NUMBER: 331881480
VISIT DATE: 07/17/2024
NARRATIVE
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being treated. A follow up visit is also noted be made today 7/17/24. Per the service report dated 2/15/24 there were two rooms that were both treated for bed bugs and German cockroaches. On 2/27/24 an inspection was conducted the same two rooms that were treated on 2/15/24 and there was no activity found.

In addition there was nothing documented on the pest control invoices to support that the facility has or had termites, or rats. Per Executive Director Molly, there have not been any reports or observed activity for the alleged pests (termites and rats). The local exterminator comes to the facility on a semi monthly basis, but will come if needed for any additional reports of pests in between scheduled service dates. Service reports were reviewed and revealed that the exterminator does come to the facility on a consistent basis. For this year (2024) the following visits were made 1/19, 1/29, 1/30, 2/15, 2/27, 3/8, 3/22, 4/10, 4/26, 5/10, 5/25, 6/20, 6/28, 7/13 were provided and details the service that was performed on that day,

Based on interviews and record review the allegation of Licensee is not properly addressing pest issue in the facility is unfounded. A finding that the complaint is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

An exit interview was conducted and a copy of this report was reviewed and provided to Molly Bowie, Executive Director.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024
LIC9099 (FAS) - (06/04)
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