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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 365530001
Report Date: 12/20/2023
Date Signed: 12/20/2023 01:47:00 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/11/2023 and conducted by Evaluator Anna Bueno
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20231211123138
FACILITY NAME:BEBING HOME CAREFACILITY NUMBER:
365530001
ADMINISTRATOR:ZAPANTA, MAX M.FACILITY TYPE:
740
ADDRESS:17446 MADRONE STREETTELEPHONE:
(909) 574-6832
CITY:FONTANASTATE: CAZIP CODE:
92337
CAPACITY:6CENSUS: 4DATE:
12/20/2023
UNANNOUNCEDTIME BEGAN:
11:42 AM
MET WITH:Max ZapantaTIME COMPLETED:
01:48 PM
ALLEGATION(S):
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Facility staff did not meet resident's hygiene needs.
Facility staff did not ensure that resident wore clean clothing.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced visit to the facility to initiate the investigation of the above mentioned allegations and deliver findings. LPA identified herself to facility staff who was informed of the reason for today’s visit. Staff phoned administrator Max Zapanta and LPA explained to Zapanta the reason for today's visit. Zapanta arrived at the facility shortly. The investigation included interviews, facility observations, and records review. The Department was not able to interview Resident 1 (R1).

The allegations are that Facility staff did not meet (R1) hygiene needs AND that Facility staff did not ensure that R1 wore clean clothing. It was alleged that on 12/7/23, Witness (W1) visited R1 and found them with a full dirty brief and in dirty clothing. During today's visit, LPA observed all residents in care appear to be well groomed and in clean clothes. LPA reviewed R1 records that show R1 is able to independently transfer to and from their bed and are ambulatory with their walking assistive device. R1 records further state that they are able to do their own thing in the bathroom but that R1 needs shower assistance. LPA reviewed text message correspondence between facility staff and R1's responsible party (RP) on 12/2/23 notifying RP that R1 was observed with a change in medical condition.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Anna Bueno
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 56-AS-20231211123138
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME: BEBING HOME CARE
FACILITY NUMBER: 365530001
VISIT DATE: 12/20/2023
NARRATIVE
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Another correspondence dated 12/4/23 showed that facility staff notified RP that R1 received new medication to treat their acute condition. Facility records also show that W1 visited R1 at least once a month. Interviews with residents revealed that staff provide assistance with hygiene, toileting, and shower needs. Staff interviews deny that residents are left soiled throughout the day and stated that residents who wear briefs are changed as needed. Based on the information, the allegations are therefore unsubstantiated.

A finding of UNSUBSTANTIATED means although the allegations may have happened or are valid, there is no preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted with administrator Max Zapanta and a copy of this report was provided.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Anna Bueno
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
LIC9099 (FAS) - (06/04)
Page: 1 of 3