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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361800187
Report Date: 11/25/2024
Date Signed: 11/25/2024 01:53:04 PM

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
11/20/2024 and conducted by Evaluator Sarina Ramirez
COMPLAINT CONTROL NUMBER: 56-AS-20241120141939
FACILITY NAME:ROSE VALLEY REDLANDSFACILITY NUMBER:
361800187
ADMINISTRATOR:GLENN BERNALFACILITY TYPE:
740
ADDRESS:153 S DEARBORN STTELEPHONE:
(909) 389-7586
CITY:REDLANDSSTATE: CAZIP CODE:
92374
CAPACITY:6CENSUS: 6DATE:
11/25/2024
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:House Manager Mistie FeltonTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not have a fire evacuation plan at the facility
Staff do not have an infection control plan at the facility
Staff are not following reporting requirements
Staff left residents unattended
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPAs) Sarina Ramirez and Becky Mann conducted an unannounced visit to the facility to conduct a complaint investigation on the above allegations. LPAs met with House Manager Mistie Felton, and discussed the purpose of the visit.

Regarding the allegation #1 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff has a fire evacuation plan, staff stated their meeting point is outside infront of the facility.
LPAs observed and reviewed records the last fire drill conducted was 10/07/24

Regarding the allegation #2 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff has a infection control plan, LPAs observed and reviewed records facility has a infection control plan
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Sarina Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2024
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-20241120141939
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: ROSE VALLEY REDLANDS
FACILITY NUMBER: 361800187
VISIT DATE: 11/25/2024
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
Regarding the allegation #3 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff follow reporting requirements.

Regarding the allegation #4 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff do not leave residents unattended.

LPA Ramirez and LPA Mann conducted 5 resident interviews. 5 out of the 5 residents informed LPAs staff do not leave residents unattended.

Based on LPAs observations, record review, and interviews, the above allegations are Unsubstantiated; meaning that 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.

An exit interview was conducted where this report was discussed and a copy with appeal rights was provided to House Manager Mistie Felton at the conclusion of the visit.


SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Sarina Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2