366426422-10-31-2023-56-AS-KCLS-CXCQNK-20231107111913

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 366426422
Report Date: 10/02/2023
Date Signed: 10/31/2023 02:42:07 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
, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/27/2023 and conducted by Evaluator Bernadette Allen

COMPLAINT CONTROL NUMBER: 56-AS-20230927090814

FACILITY NAME:	ROSE GARDEN RESIDENTIAL CARE		FACILITY NUMBER:	366426422
ADMINISTRATOR:	MORGAN E. WILLIAMS		FACILITY TYPE:	740
ADDRESS:	1350 WABASH AVE.		TELEPHONE:	(909) 794-1040
CITY:	MENTONE	STATE: CA	ZIP CODE:	92359
CAPACITY:	63	CENSUS: 59	DATE:	10/02/2023
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	DicinaTurner Administrator		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff interfered with a visitation to a resident while in care
Staff did not properly groom a resident while in care
Staff did not properly maintain a resident's room
Staff did not provide adequate care and supervision to a resident
Staff retaliated against a resident while in care
Staff unlawfully evicted a resident while in care
Staff did not ensure a resident was properly fed while in care
Staff did not safeguard a resident's personal belongings

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bernadette Allen an conducted an unannounced visit to initiate and deliver findings for the allegations above. LPA Allen met with Dicina Turner Administrator who was informed of the purpose of the visit.
LPA attempted to interview six (6) residents (R1, R2, R3, R4, R5 and R6) who could not confirm of deny that their personal rights had been violated by not being allowed to have a clean room, visitors not being allowed, not being properly groomed,staff not providing adequate supervision, being retaliated against, unlawfully being evicted and not properly feed.

LPA interviewed six staff members (S1, S2, S3, S4, S5 and S6) and all staff members stated that they have not witnessed any of the client’s personal rights being violated by not being allowed to have a clean room, visitors not being allowed, not being properly groomed, staff not providing adequate supervision, being retaliated against, unlawfully evicted and not being properly feed. During the visit LPA observed residents having visitors, lunch was being served meatloaf mash potatoes, mixed vegetables juice/water/milk.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:	DATE: 10/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2023

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-20230927090814

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: 10/02/2023

NARRATIVE

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LPA observed rooms in Unit A, Unit B, Unit I, Unit E, and Unit H and all rooms were adequately furnished, clean, and free of obstructions. During the visit LPA observed nine (9) staff members which was adequate staffing at the time of visit. LPA interviewed Danica Turner who stated no resident has been unlawfully evicted therefore she couldn’t provide any documentation that could confirm or deny that a client(s) has been unlawfully evicted from the facility.

Based on interviews with the staff, clients, and observations the findings are 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 where this report was discussed and provided to Danica Turner with appeal rights at the conclusion of the visit.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:	DATE: 10/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2023

LIC9099 (FAS) - (06/04)

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