366413073-6-6-2025-56-AS-EMAN-DHLVN9-20250613163442

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 366413073
Report Date: 06/06/2025
Date Signed: 06/06/2025 12:05:18 PM

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
03/05/2025 and conducted by Evaluator Paola Guerrero

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20250305093325

FACILITY NAME:	HERITAGE COURT ASSISTED LIVING		FACILITY NUMBER:	366413073
ADMINISTRATOR:	SCHLOTTMAN, JACOB		FACILITY TYPE:	740
ADDRESS:	275 GARNET WAY B		TELEPHONE:	(909) 204-5000
CITY:	UPLAND	STATE: CA	ZIP CODE:	91786
CAPACITY:	88	CENSUS: 36	DATE:	06/06/2025
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Ricardo Lara		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Staff do not prevent residents from smoking inside of the facility
Staff do not ensure that the facility is maintained sanitary
Staff do not provide residents with housekeeping service
Staff do not provide residents with laundry service
Staff do not provide residents with clean linen

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Facility Administrator Ricardo Lara and explained the purpose of the visit. The investigation consisted of interviews, observations, and review of records.

First allegation: Staff do not prevent residents from smoking inside of the facility. Regarding the allegation stated above LPA conducted interviews with four residents who informed LPA that facility does not allow residents to smoke inside the facility. Four out of four residents informed LPA that facility provides residents with smoking areas outside the facility for residents to smoke at. LPA conducted review of record and observed that Resident #1 has been redirected by staff about the safety concerns regarding smoking inside the facility. In addition, LPA observed that R#1 was placed on a behavior plan regarding the use of illegal drugs, smoking inside the facility, and hygiene.

Second allegation, Staff do not ensure that the facility is maintained sanitary. Regarding the first allegation LPA received pictures pertaining to Resident #1 room and its sanitation condition.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2025

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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Control Number 56-AS-20250305093325

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: HERITAGE COURT ASSISTED LIVING	FACILITY NUMBER: 366413073
	VISIT DATE: 06/06/2025

NARRATIVE

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During the review Photos evidence demonstrated R#1 room to have biohazard material such as feces smeared all over R#1 bedroom floor and inside R#1 trash can. in addition, pictures also demonstrated bodily fluids such as urine to be on R#1 bedroom floor leading towards R#1 bathroom floor. LPA conducted an interview with Facility Administrator who informed LPA that R#1 has on going behaviors pertaining to hygiene and R#1 defaecating. Administrator informed LPA that facility has been redirecting R#1 regarding R#1 behavior. In addition, Administrator provided LPA with sheet long demonstrating that facility has increase the times R#1 sheets get changed because of R#1 on going behaviors. Furthermore, LPA observed that laundry service along with shower schedule for R#1 increased to help maintain R#1 room clean, sanitary, and assist R#1 with proper hygiene. LPA conducted interviews with residents and four out of four residents informed LPA that housekeeping help maintain the facility clean and sanitary.

Third allegation: Staff do not provide residents with housekeeping service. Regarding the allegation LPA conducted interviews with residents and four out of four residents informed LPA that housekeeping service is provided daily. In addition, four out of four residents informed LPA that housekeepers are consistent with their schedules and times of when they clean their room and the facility. LPA collected documentation and observed the times and schedules of when housekeeping services are provided.

Fourth allegation: Staff do not provide residents with laundry service. Regarding the allegation LPA conducted interviews with residents and four out of four residents informed LPA that they receive laundry services provided by the facility. LPA observed based on laundry schedule that times of services differ based on each resident’s needs. LPA observed that Resident #1 receives laundry service three times a week due to ongoing behaviors and poor hygiene.

Fifth allegation: Staff do not provide residents with clean linen. Regarding the allegation “Staff do not provide residents with clean linen” LPA received pictures pertaining to R#1 bed and linens during observation LPA observed R#1 linens to have large amount of stain marks that appeared to look like urine along with blood stains. LPA conducted interview with Facility Administrator who informed LPA that Resident #1 has ongoing behaviors where R#1 urinates or defecates on self. Administrator provided LPA with progress notes pertaining to R#1 behaviors and redirection that has been implemented for R#1. In addition, LPA observed that R#1 sheet change have increased, and facility is changing resident #1 sheets daily and as needed to meet residents’ behavior needs. LPA conducted a walkthrough of resident#1 room and witnessed resident’s room to be clean along with residents’ bed and sheets.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2025

LIC9099 (FAS) - (06/04)

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Control Number 56-AS-20250305093325

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: HERITAGE COURT ASSISTED LIVING	FACILITY NUMBER: 366413073
	VISIT DATE: 06/06/2025

NARRATIVE

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Based on corroborating evidence obtained during the course of the investigation, LPA has determined that the above allegation is Unsubstantiated.

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) was discussed, and a copy was provided to Facility Administrator Ricardo Lara at the end of the visit.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2025

LIC9099 (FAS) - (06/04)

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