361880919-8-26-2024-56-AS-EMAN-DEYT2R-20250321142110

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361880919
Report Date: 08/26/2024
Date Signed: 08/26/2024 11:47:09 AM

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
03/05/2024 and conducted by Evaluator Mary Rico

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240305091344

FACILITY NAME:	LOVE 2 CARE HOMES		FACILITY NUMBER:	361880919
ADMINISTRATOR:	JACKSON, TERRI		FACILITY TYPE:	740
ADDRESS:	19432 US HIGHWAY 18		TELEPHONE:	(760) 297-6277
CITY:	APPLE VALLEY	STATE: CA	ZIP CODE:	92307
CAPACITY:	6	CENSUS: 3	DATE:	08/26/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Eula Jones		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are not adequately trained to meet resident needs.
Facility accepted a resident who requires a higher level of care.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with care giver Eula Jones and contacted the Administrator Terri Jackson by a phone call. LPA explained the purpose of the visit. The investigation consisted of staff interviews, client interviews and record review.

For the allegation, Staff are not adequately trained to meet resident needs.

During staff interviews 3 out of the 3 staff stated they are trained to meet residents needs. 1 out of the 3 staff stated, all staff members are trained before providing care. During resident interviews 2 out of the resident stated all staff members assist with their ADLs.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2024

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-20240305091344

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: LOVE 2 CARE HOMES	FACILITY NUMBER: 361880919
	VISIT DATE: 08/26/2024

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

During record review, LPA received copies of staff members training.

For the allegation, Facility accepted a resident who requires a higher level of care.

During staff interviews, 2 out for the 3 staff informed LPA they are not aware of a higher-level care resident. 3 out of the 3 staff stated, that when R1 returned from the hospital. They were trained to provided proper care. 3 out of the 3 staff stated that R1 family’s is now requesting one on one care to be provided. The facility does not provide one on one care.

Based on the evidence found during the investigation, the (2) allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation 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.

An exit interview was conducted, and this report (LIC9099) was discussed and provided Eula Jones.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 2