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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361881134
Report Date: 04/24/2025
Date Signed: 04/24/2025 05:40:05 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
04/22/2025 and conducted by Evaluator Lavette Farlow
COMPLAINT CONTROL NUMBER: 56-AS-20250422081702
FACILITY NAME:ALLARA SENIOR LIVINGFACILITY NUMBER:
361881134
ADMINISTRATOR:HEFNER, LEEANNFACILITY TYPE:
740
ADDRESS:9417 19TH STREETTELEPHONE:
(909) 736-1900
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91701
CAPACITY:120CENSUS: 86DATE:
04/24/2025
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Matt Ryan, Executive DirectorTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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9
Staff did not assist resident(s) with personal care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) LaVette Farlow arrived to facility to conduct a complaint investigation regarding the above allegation. LPA Farlow met with Executive Director Matt Ryan and explained the elements of the complaint.

Regarding the allegation that Staff did not assist resident(s) with personal care. LPA interviewed eight (8) out of eight (8) staff and the interview reveal that staff are assisting residents with personal care. Inteview with S5, and S6 revealed that S8 is not assisting staff with resident in care or is not available to assist staff. LPA interviewed eleven (11) out of eleven (11) residents in care. Eleven out of eleven resident in care revealed that they did not have any concerns or issues with staff providing personal care. LPA interview revealed that 5 out of 11 resident needed assistance with showers, in and out of wheelchair, or in and out of bed. LPA's interview with those 5 residents in care stated that staff are very helpful and assistance them without any issues. During todays visit LPA observed staff assisting residents in care and ensuring their personal needs were met.
***continued on LIC 9099C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
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-20250422081702
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: ALLARA SENIOR LIVING
FACILITY NUMBER: 361881134
VISIT DATE: 04/24/2025
NARRATIVE
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Based on the information obtained there is not enough evidence that staff did not assist resident(s) with personal care. Therefore, the allegation are deemed UNSUBSTANTIATED at this time. Unsubstantiated; meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted where this report LIC 9099 and LIC9099C was discussed, and a copy was provided Melissa Oseguera, Vibrant Life Director, at the end of the visit.

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2