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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 11:37:14 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-20220718161418
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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Staff are not following resident's advanced directives regarding who makes decisions for resident's care
Staff do not meet resident's toileting needs
Staff do not keep the facility free from odor
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 staff are not following resident’s advanced directives regarding who makes decisions for resident’s care. Information received indicated spouse of Resident #1 (R1) continued to make decisions about R1’s care despite R1’s spouse’s declining cognitive condition. LPA’s record review revealed R1 had been admitted and receiving hospice care since December 2021. LPA’s review of R1’s advance healthcare directives revealed R1’s spouse was the designated agent to make healthcare decisions. 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 2
Control Number 18-AS-20220718161418
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 further review of R1’s spouse’s physician’s report revealed R1’s spouse was not diagnosed with dementia, thus was still able to make healthcare decisions for R1. The Department’s investigation did not provide enough information to corroborate the allegation that staff are not allowing resident’s advanced directives regarding who makes decisions for resident’s care. Based on records review, this allegation is unsubstantiated.

It was alleged that the staff do not meet resident’s toileting needs. Information received indicated visitors were instructed to wait for half an hour before they could enter. LPA’s interview with R1 revealed R1 manages their own toileting needs. However, LPA’s review of R1’s physician’s report and facility care plan revealed R1 required incontinence care. LPA’s review of the facility’s plan of operation revealed that staff will provide incontinence care every two (2) hours and as needed. LPA interviewed eight (8) staff members, all of whom stated incontinence care is provided every 2 hours and/or as needed. All the staff interviewed stated they were not required to keep logs for incontinence care provided. LPA’s interview with two (2) additional residents and their responsible parties corroborated the staff’s statement. Based on interviews conducted and record review, this allegation is unsubstantiated.

It was alleged that staff do not keep the facility free from odor. According to the information received, R1’s room always had strong urine odor. LPA’s interview with R1 revealed R1 did not have any concerns about odor in the room. LPA’s interview with the Administrator revealed the odor from R1’s room was due to R1’s health condition, not from lack of maintenance or cleaning. The Administrator stated the residents’ rooms had been thoroughly cleaned by housekeeping staff regularly, and the same housekeeping staff also took care of R1’s laundry needs. LPA conducted interviews with two (2) residents and their responsible parties stated the facility was free from any odor. LPA’s interview with eight (8) staff members corroborated the Administrator’s statement. LPA’s onsite observation also revealed the facility was free from any odor. The Department’s investigation did not provide enough information to corroborate the allegation that staff do not keep the facility free from odor. Based on record review and 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 2