<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 330908249
Report Date: 08/30/2021
Date Signed: 08/30/2021 11:46:40 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
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/07/2020 and conducted by Evaluator Jennifer Semin
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20200107133532
FACILITY NAME:PRIOR'S BOARD AND CAREFACILITY NUMBER:
330908249
ADMINISTRATOR:MAE PRIORFACILITY TYPE:
735
ADDRESS:6121 JUPITER DRIVETELEPHONE:
(951) 685-4912
CITY:MIRA LOMASTATE: CAZIP CODE:
91752
CAPACITY:6CENSUS: 4DATE:
08/30/2021
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Mae PriorTIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff yells at residents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program analyst (LPA) Jennifer Semin conducted an unannoiunced visit to deliver the finding for the above conmplaint allegation. LPA met with Mae Prior.

The investigation consisted of interviews with relavent parties. Staff interviews revealed staff deny yelling at clients. Client interviews revealed that staff do not yell at clients. Investigation did not reveal further information to either refute or corroborate the allegation.

Based upon interviews and information gathered, and 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, therefore the allegations are UNSUBSTANTIATED at this time.

An exit interview was conducted where this report was discussed and provided to Ms. Prior.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Jennifer Semin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021
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