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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361880786
Report Date: 06/05/2024
Date Signed: 06/06/2024 08:10:49 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/29/2024 and conducted by Evaluator Magda Malcore
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240529094451
FACILITY NAME:SUMMERFIELD OF REDLANDSFACILITY NUMBER:
361880786
ADMINISTRATOR:HEDI CHARETTEFACILITY TYPE:
740
ADDRESS:1319 BROOKSIDE AVENUETELEPHONE:
(909) 793-9500
CITY:REDLANDSSTATE: CAZIP CODE:
92373
CAPACITY:75CENSUS: 48DATE:
06/05/2024
UNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Heidi Charette - Executive DirectorTIME COMPLETED:
03:25 PM
ALLEGATION(S):
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Staff did not ensure residents call buttons are working.

INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced visit to the facility to initiate a complaint investigation. LPA met with Heidi Charette, Executive Director and explained the purpose of the visit.
Regarding the allegation, staff did not ensure residents call buttons are working, call buttons were inspected at random in separate wings of the facility. The signal system button in room 100 was tested and observed to be non-operational.
Based on LPA observations, the allegation is Substantiated. A finding that the complaint is Substantiated means that the allegation(s) is valid because the preponderance of the evidence standard has been met.
An exit interview was conducted where reports (LIC9099&LIC9099-D) were discussed and a copy with Appeal Rights was provided at the conclusion of the visit.


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024
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-20240529094451
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: SUMMERFIELD OF REDLANDS
FACILITY NUMBER: 361880786
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/19/2024
Section Cited
CCR
87303(a)
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(a) The facility shall be clean, safe, sanitary and in good repair at all times. This requirement is not met as evidence by:
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The Executive Director stated that maintenance staff would check the battery in the call system before the end of the day. The Executive Director stated that the call system button in room 100 is now working properly. The Executive director shall provide a certification statement confirming that the signal system is working properly.
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The Licensee did not comply with the section cited by the signal system in room 100 was not operating; which poses/posed a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024
LIC9099 (FAS) - (06/04)
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