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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 365530075
Report Date: 07/11/2025
Date Signed: 07/11/2025 04:33:53 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 Becky Mann
COMPLAINT CONTROL NUMBER: 56-AS-20241120130951
FACILITY NAME:CANYON VIEW COUNTRY HOMEFACILITY NUMBER:
365530075
ADMINISTRATOR:CREIGHTON, IRENFACILITY TYPE:
740
ADDRESS:418 HASTINGS ST.TELEPHONE:
(909) 548-1769
CITY:REDLANDSSTATE: CAZIP CODE:
92373
CAPACITY:6CENSUS: 6DATE:
07/11/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Iren Creighton, AdministratorTIME COMPLETED:
04:40 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff consume liquor while on shift
Staff do not have fingerprint clearance
Staff lock facility doors to prevent residents from leaving
Staff insert suppositories to residents in care
Staff did not complete required trainings
Staff facility records are falsified
Staff did not maintain resident records
Residents are not provided proper food service
Staff did not ensure resident’s diapering needs were met
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Becky Mann conducted an unannounced visit to the facility to initiate a complaint investigation. LPA met with Iren Creighton, Administrator and explained the purpose of the visit. The investigation consisted of LPA pertinent record reviews, observations and interviews with staff and residents.

First allegation, staff consume liquor while on shift. LPA conducted a walk through of the facility. LPA inspected kitchen cabinets, and appliances, and liquor was not observed during the inspection. LPA interviewed four (4) residents. Two (2) residents denied witnessing staff consuming liquor while providing care. Two (2) other residents were unable to answer due to cognitive impairment. LPA interviewed three (3) staff, all staff denied consuming or storing liquor at the facility. Staff has not witnessed another staff consume liquor while providing care to residents.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Becky Mann
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2025
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 8
Control Number 56-AS-20241120130951
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: CANYON VIEW COUNTRY HOME
FACILITY NUMBER: 365530075
VISIT DATE: 07/11/2025
NARRATIVE
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Second allegation, staff do not have fingerprint clearance. LPA retrieved a facility roster via Guardian Background System and observed that Staff #1 (S1), Staff #2 (S2) and Staff #3 (S3) that are currently working at the facility were eligibly cleared. LPA conducted a file review for Staff 1-3 and discovered that all clearance records were on file.

Third allegation, staff lock facility doors to prevent residents from leaving. LPA conducted a walk through of the facility and inspected resident's bedrooms and doorknobs. LPA observed that no latches and/or child proof locks were in place. LPA conducted an inspection on all doors and emergency exits and observed that no latches and/or child proof locks were in place. Two (2) residents interviewed deny being locked or prevented from leaving the facility. Two (2) other residents interviewed were unable to answer due to cognitive impairment. Three (3) staff interviewed denied locking and/or preventing residents from leaving the facility.

Fourth allegation, staff insert suppositories to residents in care. Three (3) staff interviewed denied utilizing or inserting suppositories to residents. Two (2) residents interviewed denied staff inserting suppositories for the residents. Two (2) other residents interviewed were unable to answer due to cognitive impairment. Staff #2 (S2) mentioned that Resident #1 (R1) does use suppository. The nurse from Brookside Hospice comes to the facility to assist R1 with the suppository.

Fifth allegation, staff did not complete required trainings. LPA conducted staff file reviews and observed that training was completed. LPA observed certificates of completion to be on file for staff.

Sixth allegation, staff facility records are falsified. LPA conducted a First Aid & CPR verification through National CPR Foundation and New Life CPR, these agencies are used by the facility to certify staff. Staff 1-3 are certified for First Aid & CPR certification.

Seventh allegation, staff did not maintain resident records. LPA conducted a file review for three (3) residents and observed that all required documentation were on file based on Title 22 Residential Care Facility for Elderly (RCFE).
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Becky Mann
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 8
Control Number 56-AS-20241120130951
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: CANYON VIEW COUNTRY HOME
FACILITY NUMBER: 365530075
VISIT DATE: 07/11/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
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12
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14
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Eight allegation, residents are not provided proper food service. LPA conducted an inspection on facilities food supply and observed that the facility has adequate amount of food supply to meet resident needs. LPA observed that all food including canned goods sustained current shelf life. Two (2) residents interviewed stated that the food is good and has no concerns. Two (2) other residents interviewed were unable to answer due to cognitive impairment.

Ninth allegation, staff did not ensure resident’s diapering needs were met. Three (3) staff interviewed stated that they do ensure that resident's diapering needs are being met. Resident #2 (R2) stated that they do not use diapers. Resident #3 (R3) stated that staff does ensure that their diapering needs are met. Two (2) other residents interviewed were unable to answer due to cognitive impairment. Based on LPA observations, residents diapering needs are being met, the residents are kept clean and free of odors.

Based on evidence obtained during this investigation, the allegations above are 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 was discussed and a copy of this report was provided to Iren Creighton at the conclusion of the visit.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Becky Mann
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 8
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 Becky Mann
COMPLAINT CONTROL NUMBER: 56-AS-20241120130951

FACILITY NAME:CANYON VIEW COUNTRY HOMEFACILITY NUMBER:
365530075
ADMINISTRATOR:CREIGHTON, IRENFACILITY TYPE:
740
ADDRESS:418 HASTINGS ST.TELEPHONE:
(909) 548-1769
CITY:REDLANDSSTATE: CAZIP CODE:
92373
CAPACITY:6CENSUS: 6DATE:
07/11/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Iren Creighton, AdministratorTIME COMPLETED:
04:40 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not inform resident’s physician of resident’s change of condition
Staff did not provide adequate medication assistance to residents in care
Staff refuse to call an ambulance for residents in care
Staff threatened residents in care
Staff did not ensure sufficient food items were available at the facility for residents in care
Staff did not prevent residents from engaging in inappropriate interactions
Staff yelled at residents in care
Staff did not assist residents that sustained falls
Centrally stored medications are accessible to residents in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Becky Mann conducted an unannounced visit to the facility to initiate a complaint investigation. LPA met with Iren Creighton, Administrator and explained the purpose of the visit. The investigation consisted of LPA pertinent record reviews, observations and interviews with staff and residents.

The allegation that staff did not inform resident’s physician of resident’s change of condition. Staff #1 (S1) stated that they inform Innovage of any changes in the condition of residents. Based on LPA record reviews, residents have updated Needs and Services Plan that is provided through Innovage called PACE Re-Evaluation Plan of Care.

The allegation that staff did not provide adequate medication assistance to residents in care. Two (2) residents interviewed stated that they receive medication on a timely manner. Two (2) other residents interviewed were unable to answer due to cognitive impairment.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Becky Mann
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 8
Control Number 56-AS-20241120130951
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: CANYON VIEW COUNTRY HOME
FACILITY NUMBER: 365530075
VISIT DATE: 07/11/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
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20
21
22
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25
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Staff #1 (S1) and Staff #2 (S2) stated that they do provide adequate medication assistance to residents. LPA conducted file reviews of residents Medication Administration Record (MAR) and observed that all medication is being distributed and managed correctly by staff.

The allegation that staff refuse to call an ambulance for residents in care. Two (2) residents interviewed stated that staff has not refused to call ambulance for residents. Two (2) other residents interviewed were unable to answer due to cognitive impairment. Three (3) staff interviewed stated denied refusing to call an ambulance for residents in care.

The allegation that staff threatened residents in care. Two (2) residents interviewed stated that staff has not threatened residents .Two (2) other residents interviewed were unable to answer due to cognitive impairment. Three (3) staff interviewed stated denied threatening residents in care.

The allegation that staff did not ensure sufficient food items were available at the facility for residents in care. LPA conducted an inspection on facility's food supply and observed that there is an adequate amount of food supply to meet resident needs. Two (2) residents interviewed stated that the food provided is fulfilling and have no issues with the food. Two (2) other residents interviewed were unable to answer due to cognitive impairment.

The allegation that staff did not prevent residents from engaging in inappropriate interactions. Two (2) residents interviewed stated that they have not engaged in inappropriate interactions and have not witnessed inappropriate interactions at the facility. Two (2) other residents interviewed were unable to answer due to cognitive impairment. Three (3) staff interviewed stated that they do prevent residents from engaging in inappropriate interactions.

The allegation that staff yelled at residents in care. Two (2) residents interviewed stated that staff has not yell at residents in care or witnessed it at the facility. Two (2) other residents interviewed were unable to answer due to cognitive impairment. Three (3) staff interviewed stated deny yelling at residents in care and have not witnessed a staff yelling at a resident in care.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Becky Mann
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 8
Control Number 56-AS-20241120130951
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: CANYON VIEW COUNTRY HOME
FACILITY NUMBER: 365530075
VISIT DATE: 07/11/2025
NARRATIVE
1
2
3
4
5
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The allegation that staff did not assist residents that sustained falls. Two (2) residents interviewed stated that staff does assist residents with transfers and are very involved and deny witnessing residents sustain falls and not being assisted by staff. Two (2) other residents interviewed were unable to answer due to cognitive impairment. Three (3) staff interviewed stated that they do assist residents in care.

The allegation that centrally stored medications are accessible to residents in care. LPA conducted a walk through of the facility and observed that the medications are locked and secured in the kitchen cabinets. During the inspection, staff opened the cabinets with a magnet and demonstrated that medication cabinets remain locked and inaccessible to residents in care.

Based on evidence obtained during this investigation, the allegations above are 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 was discussed and a copy of this report was provided to Iren Creighton at the conclusion of the visit.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Becky Mann
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 8
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 Becky Mann
COMPLAINT CONTROL NUMBER: 56-AS-20241120130951

FACILITY NAME:CANYON VIEW COUNTRY HOMEFACILITY NUMBER:
365530075
ADMINISTRATOR:CREIGHTON, IRENFACILITY TYPE:
740
ADDRESS:418 HASTINGS ST.TELEPHONE:
(909) 548-1769
CITY:REDLANDSSTATE: CAZIP CODE:
92373
CAPACITY:6CENSUS: 6DATE:
07/11/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Iren Creighton, AdministratorTIME COMPLETED:
04:40 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 Analyst (LPA) Becky Mann conducted an unannounced visit to the facility to initiate a complaint investigation. LPA met with Rosa Gaxiola, House Manager and explained the purpose of the visit. The investigation consisted of LPA pertinent record reviews, observations and interviews with staff and residents.

The allegation that staff do not have a fire evacuation plan at the facility. LPA conducted a walkthrough of the facility and observed proper fire evacuation posters posted in the facility. LPA conducted a record review and observed that the last evacuation was completed in June 2025. LPA observed exit signs throughout the facility. In addition, staff informed LPA that the main entry door is their primary exit in case of a fire.

The allegation that staff do not have an infection control plan at the facility. LPA conducted a record review and observed that the facility has in an infection control plan and is current. In addition, LPA observed that proper postings throughout the facility were indicated with preventions and the spread of infections and illnesses.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Becky Mann
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 7 of 8
Control Number 56-AS-20241120130951
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: CANYON VIEW COUNTRY HOME
FACILITY NUMBER: 365530075
VISIT DATE: 07/11/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
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11
12
13
14
15
16
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The allegation that staff are not following reporting requirements. LPA conducted interviews with staff who informed LPA that Special Incident Reports (SIR) are faxed to Community Care Licensing Division (CCLD) when pertaining to any incident involving residents in care.

The allegation that staff left residents unattended. Two (2) residents interviewed denied being left alone and/or unattended at the facility. Two (2) other residents interviewed were unable to answer due to cognitive impairment. Three (3) staff interviewed denied leaving residents unattended or unsupervised.

Based on evidence obtained during this investigation, the allegations above are 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 was discussed and a copy of this report was provided to Iren Creighton at the conclusion of the visit
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Becky Mann
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2025
LIC9099 (FAS) - (06/04)
Page: 8 of 8