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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366425270
Report Date: 05/26/2021
Date Signed: 05/26/2021 02:51:06 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
08/27/2020 and conducted by Evaluator Javina George
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20200827162255
FACILITY NAME:ABRIA DEL CIELOFACILITY NUMBER:
366425270
ADMINISTRATOR:CRISELDA ESPIRITU SANTOFACILITY TYPE:
740
ADDRESS:1589 N. WATERMAN AVETELEPHONE:
(909) 884-4757
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY:240CENSUS: 160DATE:
05/26/2021
UNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Administrator MaCriselda Espirtu Santo TIME COMPLETED:
02:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility failed to safeguard resident's possessions
Unlawful eviction
Staff yelled at resident
Resident is not treated with dignity by facility staff
Facility infested with pests
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Javina George arrived at the facility for the purpose of delivering findings for the above allegation. LPA George met with Administrator MaCriselda Espirtu Santo and advised of the purpose of the visit. The investigation consisted of a tour of the facility, interviews, and file reviews for residents and staff.

Allegation #1 Facility failed to safeguard resident's possessions.
Resident #1 (R1) stated that some of their belongings went missing such as shoes and food items. While conducting interviews R1 informed LPA that the shoes had been located inside of their room, and were not stolen. While conducting a tour of the facility on 7/3/20, LPA observed a lock placed on the mini refrigerator located in R1s room. It was explained that it was a result of R1 stating that there was some cheese that had been eaten. To prevent any items to become missing in the future the facility provided R1 with a lock, and at the time of the complaint R1 was already in possession of the lock. Therefore the allegation of facility failed to safeguard residents possessions is UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2021
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 4
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
08/27/2020 and conducted by Evaluator Javina George
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20200827162255

FACILITY NAME:ABRIA DEL CIELOFACILITY NUMBER:
366425270
ADMINISTRATOR:CRISELDA ESPIRITU SANTOFACILITY TYPE:
740
ADDRESS:1589 N. WATERMAN AVETELEPHONE:
(909) 884-4757
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY:240CENSUS: 150DATE:
05/26/2021
UNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Administrator MaCriselda Espirtu Santo TIME COMPLETED:
02:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident is not afforded privacy
Facility failed to provide a safe environment
Resident was not permitted to reject medical care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Javina George made an unnannouced visit to the facility to deliver findings for the above allegations. LPA met with Administrator and explained the purpose of the visit.

Allegation # 1 Resident is not afforded privacy
LPA conducted interviews and inquired if there were any concerns with the facility and if the resident's felt safe. All interviewed stated that they felt safe, and that they had their privacy, their mail is not opened when they received it, and whether they had a private or shared room, they felt that they had privacy. Resident's stated that they are able to make their phone calls, as well as receive them with no issues. The allegation Resident is not afforded privacy is UNFOUNDED. A finding that the complaint is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2021
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 4
Control Number 18-AS-20200827162255
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
RIVERSIDE, CA 92507
FACILITY NAME: ABRIA DEL CIELO
FACILITY NUMBER: 366425270
VISIT DATE: 05/26/2021
NARRATIVE
1
2
3
4
5
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7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
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32
Allegation # 2 Facility failed to provide a safe environment.
LPA conducted interviews and did not have any additional information to confirm whether this allegation had occurred. LPA inquired if there were any concerns with the facility and if they resident felt safe. All interviewed stated that they felt safe, and that if they did not some would alert staff of the issue and contact law enforcement if necessary. The allegation Facility failed to provide a safe environment UNFOUNDED. A finding that the complaint is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Allegation # 3 Resident was not permitted to reject medical care.
Based on interviews conducted residents stated that they had not been in a situation to where they would need to reject medical care, if they did they would if they wanted to. The allegation of Resident was not permitted to reject medical care is UNFOUNDED. A finding that the complaint is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

An exit interview was conducted and a copy of this report and 9099C, was provided to Administrator MaCriselda Espiritu Santo.
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 4
Control Number 18-AS-20200827162255
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
RIVERSIDE, CA 92507
FACILITY NAME: ABRIA DEL CIELO
FACILITY NUMBER: 366425270
VISIT DATE: 05/26/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Allegation # 2 Unlawful eviction.
LPA reviewed the eviction notice given and the reasons stated for the eviction were: "Not following the facility rules, not going out at this time during the outbreak of the virus (covid-19 pandemic), and to wait for the results of testing." R1 did admit that they did in fact go against what was being advised and left the facility to go and purchase a new phone. The allegation of unlawful eviction is UNSUBSTANTIATED.

Allegation # 3 Staff yelled at resident.
LPA conducted interviews with various individuals and LPA was unable to corroborate the allegation. Feedback provided was that it is the other way around with the resident's yelling at staff, rather than the staff yelling at the residents. The allegation of Staff yelled at resident is UNSUBSTANTIATED.

Allegation # 4 Resident is not treated with dignity by facility staff
Based on eleven interviews conducted all residents interviewed felt that they were treated with respect by staff and were not able to provide examples of a time where they felt that they were not treated with dignity by staff. The allegation of Resident is not treated with dignity by facility staff is UNSUBSTANTIATED.

Allegation # 5 Facility infested with pests.
The facility has had an on-going issue with pests such as bed bugs and occasionally roaches and spiders. During the visit's conducted on 8/31/20 and today 5/26/21, LPA did not observe any bed bugs or roaches. Administrator Criselda explained that the facility continues to work with the extermination company for on-going maintenance treatments and the facility also has the maintenance staff following up in between servicing by the extermination company. Therefore the allegation of Facility infested with pests is UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means 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 at this time.

An exit interview was conducted and a copy of this report and 9099C, was provided to Administrator MaCriselda Espiritu Santo.
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 4