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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366426422
Report Date: 06/21/2023
Date Signed: 08/07/2023 08:56:34 AM

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
, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/13/2023 and conducted by Evaluator Bernadette Allen
COMPLAINT CONTROL NUMBER: 56-AS-20230613150538
FACILITY NAME:ROSE GARDEN RESIDENTIAL CAREFACILITY NUMBER:
366426422
ADMINISTRATOR:MORGAN E. WILLIAMSFACILITY TYPE:
740
ADDRESS:1350 WABASH AVE.TELEPHONE:
(909) 794-1040
CITY:MENTONESTATE: CAZIP CODE:
92359
CAPACITY:63CENSUS: 58DATE:
06/21/2023
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Morgan Williams AdministratorTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
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7
8
9
Facility did not take necessary steps to prevent a scabies outbreak.
Facility is not properly cleaned.
INVESTIGATION FINDINGS:
1
2
3
4
5
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7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Bernadette Allen made an unannounced visit to initiate and deliver the findings for this complaint investigation. LPA met with Morgan Williams and discussed the purpose of today’s visit.
The investigation consisted of interviews with seven (7) residents, and nine (9) staff members.
Allegation #1 Facility did not take necessary steps to prevent a scabies outbreak: LPA interviews with facility staff, administrator Morgan Williams, and wellness director Casandra Crowley all stated there are no residents at the facility that has been diagnosed by a physician with having scabies. LPA interviewed 7 seven residents and 4 four residents stated that they don’t have a rash or scabies. Three 3 residents said that they have a rash, but they were not diagnosed as having scabies. During the interviews the wellness director she stated that if there was diagnosis /outbreak of scabies individual(s) would be isolated, staff would provide environmental disinfection and medication would be administered as proscribed by their physician.
Allegation #2 Facility is not properly cleaned: During today’s visit LPA toured the inside and outside facility grounds and observed the facility was clean. Also, LPA observed facility staff power washing the outside grounds entryway of the common area. LPA interviewed facility staff and the administrator who stated additional cleaning measures are being taken ensure the outside area is clean and free of debris.
Based on the interviews, observations and record reviewed the above findings is Unsubstantiated. A finding of unsubstantiated means although the allegations 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 with Morgan Williams and a copy was provided at the conclusion of the visit.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2023
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-20230613150538
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
, CA 92507
FACILITY NAME: ROSE GARDEN RESIDENTIAL CARE
FACILITY NUMBER: 366426422
VISIT DATE: 06/21/2023
NARRATIVE
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Based on the interviews, observations and record reviewed the above findings is Unsubstantiated. A finding of unsubstantiated means although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2