331800003-11-26-2025-18-AS-RORN-DP7UB4-20251209142545

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331800003
Report Date: 11/25/2025
Date Signed: 11/26/2025 10:43:28 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 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
07/13/2023 and conducted by Evaluator Mary G Flores

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20230713115734

FACILITY NAME:	AZZUR ASSISTED LIVING LLC		FACILITY NUMBER:	331800003
ADMINISTRATOR:	LIBERTY ALMAZAN		FACILITY TYPE:	740
ADDRESS:	397 E MAIN STREET		TELEPHONE:	(951) 665-6240
CITY:	SAN JACINTO	STATE: CA	ZIP CODE:	92583
CAPACITY:	0	CENSUS: 0	DATE:	11/25/2025
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:			TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Illegal Eviction.
Staff did not properly supervise resident in care resulting in resident being placed into an unlicensed home without approval.
Staff did not respond to Resident's Representative's requests for communication in a timely manner.

INVESTIGATION FINDINGS:

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On 7/14/23 LPA Delgado attempted to conduct an initial investigation visit regarding the above allegations. On 7/21/23 LPA Banrasavong and Regional Manager (RM) Lacey met with Licensee, Mary Jane Tolentino at the office to discuss the complaint. On 11/25/25 LPA Flores contacted Resident #1(R1)’s responsible party, and attempted to contact licensee, adminiistrator, and operator.

Allegation: Illegal Eviction.
It is alleged resident #1 was not provided with an illegal eviction.

Allegation: Staff did not properly supervise a resident in care resulting in a resident being placed into an unlicensed home without approval.
It is alleged resident #1 was moved to a location that provides unlicensed care without consent.

(CONTINUED ON LIC 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:	DATE: 11/25/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2025

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 18-AS-20230713115734

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: AZZUR ASSISTED LIVING LLC	FACILITY NUMBER: 331800003
	VISIT DATE: 11/25/2025

NARRATIVE

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Allegation: Staff did not respond to Resident's Representative's requests for communication in a timely manner.
It is alleged POA and responsible party were not notified or contacted regarding the move.

The investigation consisted and revealed the following: On 3/28/23 an office meeting was conducted via Microsoft Teams with the licensee in which the department discussed the process to follow, after the department was informed of licensee losing control of the property on 3/22/23. Licensee was informed that must provide 60-day notices to residents and responsible parties. On 11/25/25 LPA Flores interviewed R1’s responsible party who stated the facility never notified them of the closure of the facility. R1’s responsible party was told that they were conducting repairs and residents were being temporarily moved. R1 was moved to an unknown location. On 11/25/25 LPA Flores attempted to contact R1, operator of unlicensed location, administrator, and licensee and was not able to interview any of them. LPA was unable to conduct additional interviews with staff or residents since the facility has been closed since 7/21/23. Per facility’s history review the facility closed due to losing control of the property. Residents were not evicted from the facility. Due to the lack of information and the facility being closed R1’s location is unknown. Therefore, there is not enough evidence to say R1 was moved to an unlicensed care location. Although R1’s responsible party may have not been provided a 60-day notice. There is no preponderance of evidence to say that all residents were not provided a 60-day notice. Therefore the three allegations are unsubstantiated.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

The facility was closed on 7/21/23. Therefore, this report was mailed to the licensee’s last known address1980 MAIREMONT DRIVE, WALNUT, CA 91789

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:	DATE: 11/25/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2025

LIC9099 (FAS) - (06/04)

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