<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336427235
Report Date: 02/02/2023
Date Signed: 02/02/2023 12:46:13 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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
01/30/2023 and conducted by Evaluator Ryan Gardner
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20230130151135
FACILITY NAME:CORONA RESIDENTIAL CARE CENTER LLCFACILITY NUMBER:
336427235
ADMINISTRATOR:AHARON STRIKSFACILITY TYPE:
740
ADDRESS:1400 CIRCLE CITY DRTELEPHONE:
(951) 735-0252
CITY:CORONASTATE: CAZIP CODE:
92879
CAPACITY:125CENSUS: 95DATE:
02/02/2023
UNANNOUNCEDTIME BEGAN:
08:42 AM
MET WITH:Maria "Mary" Gonzalez- Administrator AssistantTIME COMPLETED:
12:55 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not treat resident with dignity and respect.
Resident was served expired food.
Staff is not following resident's special diet.
Staff is neglecting to meet resident's care needs.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Ryan Gardner conducted an unannounced visit to the facility for the purpose of initiating an investigation and delivering findings for the above complaint allegations. LPA met Administrator Assistant Maria "Mary" Gonzalez and explained the reason for the visit.

During today’s visit, LPA toured the facility, reviewed, and requested facility documents, interviewed staff, and interviewed residents.

For allegation, Staff does not treat resident with dignity and respect:

During interviews conducted, LPA did not discover evidence to collaborate that staff do not treat residents with dignity and respect.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Ryan Gardner
LICENSING EVALUATOR SIGNATURE:

DATE: 02/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2023
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 3
Control Number 56-AS-20230130151135
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: CORONA RESIDENTIAL CARE CENTER LLC
FACILITY NUMBER: 336427235
VISIT DATE: 02/02/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
For allegation, Resident was served expired food:

During facility tour, LPA visited the facility kitchen and inspected the food in the refrigerator and the freezer. LPA did not observe expired food. During document review, LPA discovered that the kitchen staff places a received date sticker on food when it is received, and kitchen staff will discard the food after a certain number of days based on a food safety chart. During interviews conducted, LPA did not discover evidence to collaborate that a resident was served expired food.

For allegation, Staff is not following resident's special diet:

During document review, LPA discovered that Resident R1 does not have doctors order for a special diet. During interviews conducted, LPA discovered that R1 prefers soft foods, but does not have a doctor’s order for a special diet. LPA did not discover evidence to collaborate that staff is not following resident’s special diet.

For allegation, Staff is neglecting to meet resident's care needs:

During document review, LPA discovered that R1’s care need from the facility is medication management. LPA reviewed R1's medication log (MARs) and confirmed R1 is receiving mediation management from the facility. LPA reviewed R1's physician report and discovered that R1 can ambulate on their own, eat on their own, and can provide self-care for grooming and bathing. During interview with R1, R1 confirmed the only care needed from the facility is medication management. LPA did not discover evidence to collaborate that staff is neglecting to meet resident’s care needs.

Based on the evidence discovered during the investigation, the four (4) allegations listed above are deemed UNSUBSTANTIATED.

A finding that the complaints are UNSUBSTANTIATED means although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Ryan Gardner
LICENSING EVALUATOR SIGNATURE:

DATE: 02/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 56-AS-20230130151135
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: CORONA RESIDENTIAL CARE CENTER LLC
FACILITY NUMBER: 336427235
VISIT DATE: 02/02/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
An exit interview was conducted, and this report was discussed and provided to Administrator Assistant Maria "Mary" Gonzalez, along with a copy of the appeal rights.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Ryan Gardner
LICENSING EVALUATOR SIGNATURE:

DATE: 02/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3