Complaint Investigation Report

374603339-2-26-2024-18-AS-JDHS-D2VRNH-20240228121017

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

RIVERSIDE AC/SC , 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

01/24/2024 and conducted by Evaluator Kathleen Banrasavong

COMPLAINT CONTROL NUMBER: 18-AS-20240124163406

Facility failed to report financial abuse to Licensing

On 01/24/2024, Community Care Licensing (CCL) received a complaint that alleged the facility failed to report financial abuse to Licensing. During the course of the investigation, LPA interviewed the Administrator, Amy Banaga. Banaga stated that she submitted the Unusual Incident/ Injury Report to the Regional Office. Administrator indicated that the incident occurred on 01/17/2024 and it was reported on 01/17/2024. LPA reviewed the serious incident report that was submitted to the regional office. LPA reviewed the facility log of serious incident reports and the serious incident report was not logged. However, it is unreasonable to state that the facility did not report the incident. There are currently no concerns regarding the facility reporting incident to the regional office.

Based on LPA’s observation, interview conducted, and record reviews, the preponderance of evidence shows that the allegations that facility failed to report financial abuse to Licensing. The Department has found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.