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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366426422
Report Date: 12/23/2024
Date Signed: 12/23/2024 08:40:32 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
09/18/2024 and conducted by Evaluator Bernadette Allen
COMPLAINT CONTROL NUMBER: 56-AS-20240918162942
FACILITY NAME:ROSE GARDEN RESIDENTIAL CAREFACILITY NUMBER:
366426422
ADMINISTRATOR:DANICA TURNERFACILITY TYPE:
740
ADDRESS:1350 WABASH AVE.TELEPHONE:
(909) 794-1040
CITY:MENTONESTATE: CAZIP CODE:
92359
CAPACITY:63CENSUS: 50DATE:
12/23/2024
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Business Office Manager Michelle ReyesTIME COMPLETED:
08:45 AM
ALLEGATION(S):
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Facility does not have adequate staffing to meet the needs of the residents in care.
Facility has bed bugs.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bernadette Allen met with Business Office Manager Michelle Reyes at Community Care Licensing Division (CCLD) Adult and Senior Care (ASC) Regional Office on 12/23/2024 at 8:00 AM to deliver the findings of the above allegations. LPA Allen explained the purpose of the requested office visit.

The investigation involved interviews with staff, residents, responsible parties, and a review of records.

Interviews with facility staff and responsible parties revealed that while staffing may have been a concern in the past, there has recently been sufficient staff to care for the residents. LPA attempted to interview residents about the presence of bed bugs in their living quarters, but they were unable to confirm or deny having bed bugs in their rooms. Responsible parties of the residents were asked if they had been notified about the bed bug issue, and they all confirmed that they were informed and that a pest control company had addressed the problem. LPA Allen was also provided with a copy of the pest control contract, confirming that immediate action was taken to resolve the issue.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2024
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-20240918162942
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: 12/23/2024
NARRATIVE
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Based on the evidence gathered during the investigation, the above allegations are found to be Unsubstantiated; meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted where this report was discussed and provided to Business Office Manager MIchelle Reyes at the conclusion of the visit with appeal rights.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2