Complaint Investigation Report

336407734-5-15-2024-18-AS-TDAN-D5PTWM-20240528150544

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

RIVERSIDE ASC , 1650 SPRUCE ST STE 200 MS29-27

This is an official report of an unannounced visit/investigation of a complaint received in our office on

03/05/2024 and conducted by Evaluator Sara Martinez

COMPLAINT CONTROL NUMBER: 18-AS-20240305095021

Administrative Assistant Yamberly Genesis Garcia

Staff did not conduct a preadmissions assessment

Licensing Program Analyst (LPA) Sara Martinez conducted an unannounced visit to deliver findings regarding the allegation listed above. LPA was granted entry and met with Administrative Assistant Yamberly Genesis Garcia, who was Informed of the purpose of the visit.

Regarding the allegation “Staff did not conduct a preadmissions assessment”, it was alleged Administrator Efren Rillo did not conduct a preadmissions assessment for Resident One (R1) that reflects R1's level of care. R1 was admitted to the facility on 04/24/2014. R1's Resident Appraisal form was signed and dated on 04/25/2014 revealing prior to R1's admission, a determination of the prospective resident's suitability for admission and appraisal of R1's individual service needs, feeding, toileting, transferring, and grooming was not completed. Based on records reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099 D. An exit interview was conducted, and a copy of this report was provided to Garcia.