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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366413080
Report Date: 10/14/2024
Date Signed: 10/14/2024 12:33:10 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
10/09/2024 and conducted by Evaluator Sarina Ramirez
COMPLAINT CONTROL NUMBER: 56-AS-20241009152712
FACILITY NAME:TUPARAN RESIDENTIAL CARE FACILITY INCFACILITY NUMBER:
366413080
ADMINISTRATOR:TUPARAN, LORETAFACILITY TYPE:
740
ADDRESS:1929 CHURCH STREETTELEPHONE:
(909) 894-3667
CITY:REDLANDSSTATE: CAZIP CODE:
92374
CAPACITY:6CENSUS: 4DATE:
10/14/2024
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Administrator Loreta TuparanTIME COMPLETED:
12:35 PM
ALLEGATION(S):
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Staff are not repositioning resident as needed
Staff are not ensuring resident is adequately fed resulting in resident losing weight
Staff are not ensuring safe keeping of resident's personal items
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sarina Ramirez conducted an unannounced visit to the facility to conduct a complaint investigation on the above allegations. LPA met with Administrator Lori Tuparan and explained the purpose of the visit.

Regarding the allegation #1, LPA Ramirez conducted 2 staff interviews. 2 out of the 2 staff informed LPA they reposition hospice residents every two hours.

LPA Ramirez conducted 2 hospice resident interviews. 2 out of the 2 residents stated staff reposition them every 2 hours and staff are available if reposition is needed prior to the two hour mark.

Regarding the allegation #2, LPA conducted 2 staff interviews. 2 out of the 2 staff informed LPA residents are fed three times a day and snacks in between meals throughout the day.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Sarina Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2024
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-20241009152712
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: TUPARAN RESIDENTIAL CARE FACILITY INC
FACILITY NUMBER: 366413080
VISIT DATE: 10/14/2024
NARRATIVE
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LPA Ramirez conducted 2 hospice resident interviews. 2 out of the 2 residents stated they are fed 2-3 times a day, and snacks are provided when requested. 2 out of 2 Residents stated the food portion and food quality is good.

Regarding the allegation #3, LPA conducted 2 staff interviews. 2 out of the 2 staff informed LPA residents belongings are kept safe in resident’s bedrooms. Staff #2 stated to LPA if incontinent supplies do not fit in resident’s bedroom, they are stored in the facility garage. Staff #1 informed LPA a previously employed staff had stolen incontinent supplies from facility and immediately purchased additional supplies.

LPA Ramirez conducted 2 hospice resident interviews. 2 out of the 2 residents stated their belongings are kept in their bedrooms. 2 out of 2 residents stated they do not have missing items from their rooms nor are they aware if anything has gone missing from their bedrooms.

Based on LPAs observations and interviews, the above allegations are Unsubstantiated. A finding that complaints are UNSUBSTANTIATED means although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted, and this report was discussed and provided to Administrator Lori Tuparan along with a copy of the appeal rights.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Sarina Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2