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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366426422
Report Date: 10/30/2023
Date Signed: 10/30/2023 02:48:51 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
08/23/2023 and conducted by Evaluator Bernadette Allen
COMPLAINT CONTROL NUMBER: 56-AS-20230823155415
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: 56DATE:
10/30/2023
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Leilani Cortez-LVNTIME COMPLETED:
02:50 PM
ALLEGATION(S):
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9
Staff did not prevent an outbreak of scabies.
Staff left residents in soiled diaper resulting in a rash.
Staff did not seek medical attention for residents
INVESTIGATION FINDINGS:
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3
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5
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Licensing Program Analyst (LPA) Bernadette Allen made an unannounced visit to deliver the findings for the complaint investigation. LPA met with Leilani Cortez-LVN and she was informed of the purpose of today’s visit.

The investigation consisted of interviews with staff members,residents responsible parties and the residents facility files.

Allegation #1 Facility did not take necessary steps to prevent a scabies outbreak: LPA conducted interviews with facility staff, administrator Danica Turner, and responsible parties of residents. The interviews with the staff and responsible parties have stated there are no residents at the facility that has been diagnosed by a physician with having scabies. LPA also observed residents files and there was no record or diagnosis of any residents having scabies. During the investigation the LPA was informed of the procedures if there was an diagnosis/outbreak of scabies.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023
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-20230823155415
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: 10/30/2023
NARRATIVE
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Allegation #2 Staff left residents in soiled diaper resulting in a rash and Allegation #3- Staff did not seek medical attention for residents.
The interviews with the responsible parties for residents and files reviewed all stated that they were aware of residents having a rash and files also revealed that residents in care were being treated by their physicians.

Based on the interviews and records reviewed the above 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 with Leilani Cortez-LVN and a copy of the report was provided at the conclusion of the visit with appeal rights.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2