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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800073
Report Date: 01/09/2026
Date Signed: 01/09/2026 11:38:24 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
07/18/2022 and conducted by Evaluator Seo Jeon
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20220718100037
FACILITY NAME:VINEYARD PLACEFACILITY NUMBER:
331800073
ADMINISTRATOR:ARLENE CRAWFORDFACILITY TYPE:
740
ADDRESS:24325 WASHINGTON AVETELEPHONE:
(951) 387-8410
CITY:MURRIETASTATE: CAZIP CODE:
92562
CAPACITY:82CENSUS: 63DATE:
01/09/2026
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Angela Jackson, Community Relations DirectorTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Resident developed sepsis while in care
Staff served cold food to resident
Resident is not served an adequate amount of food
Facility is unsanitary
Facility not allowing resident to receive phone calls
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Seo Jeon and Kyle Wellington conducted an unannounced visit to the facility to deliver findings of the above allegations. LPA met with Angela Jackson, Community Relations Director. The Department investigation involved interviews with staff and residents and review of records.

On 07-18-2022, Community Care Licensing (The Department) received a complaint report with the following allegations.

It was alleged that resident developed sepsis while in care. LPA’s review of records revealed Resident #1 (R1) had been admitted to the facility under dementia care plan as of 12-01-2021 and passed away on 08-28-2022. R1’s certain health conditions led to infection, and R1 was sent to a hospital on 06-17-2022. R1 was discharged on 06-26-2022 with diagnosis of sepsis. R1 developed sepsis while in care, but LPA’s review of R1’s discharge report did not reveal any information to indicate what caused R1 developing sepsis. Continued on LIC9099-C.....
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Seo Jeon
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2026
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 3
Control Number 18-AS-20220718100037
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: VINEYARD PLACE
FACILITY NUMBER: 331800073
VISIT DATE: 01/09/2026
NARRATIVE
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LPA’s interview with the Administrator did not reveal any information about how R1 developed sepsis. The Department’s investigation did not provide enough information to corroborate the allegation that resident developed sepsis while in care. Based on records review and interview conducted, this allegation is unsubstantiated.

It was alleged that staff served cold food to resident. Information received indicated R1’s food was served cold on one (1) occasion. R1’s relevant party asked a staff member to re-heat the food, but they did not do so without any explanation. LPA conducted interviews with eight (8) staff members, all of whom denied serving cold food to residents. LPA’s attempt to conduct interviews with six (6) previous staff members who worked in year 2022 were unsuccessful. LPA also conducted interviews with two (2) residents who were with their relevant parties, all of whom denied receiving cold food. The Department’s investigation did not provide enough information to corroborate the allegation that staff served cold food to resident. Based on interviews conducted, this allegation is unsubstantiated.

It was alleged that resident is not served an adequate amount of food. Information received indicated that Resident #1 (R1) ate their meal in about 2 minutes, so R1’s relevant party asked a staff member for another dish, but the staff member never came back with another dish. LPA conducted interview with eight (8) staff members, all of whom stated any resident can ask for additional plate of food if necessary. LPA’s attempt to conduct interviews with six (6) previous staff members who worked in year 2022 were unsuccessful. LPA conducted an interview with the Administrator who stated R1 often ate double portions, and staff members have provided additional plate of food upon request from R1. LPA conducted interviews with two (2) residents who were with their relevant parties, all of whom stated they had received more than enough food. The Department’s investigation did not provide enough information to corroborate the allegation that resident is not served an adequate amount of food. Based on the interviews conducted, this allegation is unsubstantiated.

It was alleged that facility is unsanitary. LPA toured the interior and exterior areas of the facility and found them to be clean and well organized without any foul odor in any of the hallways. LPA conducted an interview with the Administrator who denied the facility ever being in unsanitary condition. The Administrator stated that all caregivers and housekeepers have cleaned the facility on daily basis.

Continued on LIC9099-C....

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Seo Jeon
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 18-AS-20220718100037
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: VINEYARD PLACE
FACILITY NUMBER: 331800073
VISIT DATE: 01/09/2026
NARRATIVE
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The Administrator also stated that no one has complained about the facility being unsanitary. LPA conducted interviews with eight (8) staff members, all of whom denied the facility ever being in unsanitary conditions. LPA’s attempted interviews with six (6) previous staff members who worked in year 2022 were unsuccessful. LPA conducted interviews with two (2) residents who were with their relevant parties, all of whom stated the facility had been in very clean condition. The Department’s investigation did not provide enough information to corroborate the allegation that facility is unsanitary. Based on observations and interviews conducted, this allegation is unsubstantiated.

It was alleged that facility is not allowing resident to receive phone calls. LPA conducted an interview with the Administrator who stated that R1’s relevant party set up a phone in R1’s room. The Administrator stated that there was no way any staff members could restrict phone calls to R1. For the residents who do not own a phone, anyone can call the front desk who transfers the phone calls to medication technicians who then hand the phone calls to the residents. The Administrator stated that most residents do not own phones due to their cognitive condition. LPA’s interviews with eight (8) staff members corroborated the Administrator’s statements. LPA’s attempted interviews with six (6) previous staff members who worked in year 2022 were unsuccessful. LPA conducted interviews with two (2) residents who were with their relevant parties, all of whom stated that staff members have never restricted phone calls. The Department’s investigation did not provide enough information to corroborate the allegation that facility is not allowing resident to receive phone calls. Based on interviews conducted, this allegation is unsubstantiated.

A finding that the complaint is UNSUBSTANTIATED means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.



An exit interview was conducted where a copy of this report was provided.
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Seo Jeon
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3