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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366413073
Report Date: 08/31/2021
Date Signed: 08/31/2021 01:12:51 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
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/26/2021 and conducted by Evaluator Javier Prieto
COMPLAINT CONTROL NUMBER: 18-AS-20210826084412
FACILITY NAME:HERITAGE COURT ASSISTED LIVINGFACILITY NUMBER:
366413073
ADMINISTRATOR:SCHLOTTMAN, JACOBFACILITY TYPE:
740
ADDRESS:275 GARNET WAY BTELEPHONE:
(909) 204-5000
CITY:UPLANDSTATE: CAZIP CODE:
91786
CAPACITY:88CENSUS: 58DATE:
08/31/2021
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Jake SchlottmanTIME COMPLETED:
01:08 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Food Service inadequate.

Facility has an odor.

Resident furniture is in poor condition.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint investigation regarding allegations that the food service is inadequate, facility has an odor and resident furniture is in poor condition. LPA met with administrator Jake Schlottman and toured facility kitchen. Facility provides a menu everyday and with alternate meals. Food is of good quality and nutritional value. Residents are allowed to ask for alternate meals that are not on the menu. Facility lobby was found to be clean and cool and free of odors. Resident #1 (R1) in question was interviewed and stated no complaints with furniture or condition of room.

Based on the information obtained there is not enough evidence that food service is inadequate, facility has an odor and resident furniture is in poor condition. Therefore, the allegations are deemed UNSUBSTANTIATED at this time. 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, therefore the allegation is UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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