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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800157
Report Date: 03/19/2026
Date Signed: 03/19/2026 04:30:45 PM

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
11/14/2023 and conducted by Evaluator Deborah Lee
COMPLAINT CONTROL NUMBER: 18-AS-20231114082903
FACILITY NAME:GRACE VILLAFACILITY NUMBER:
331800157
ADMINISTRATOR:ANWULI, NKECHIFACILITY TYPE:
735
ADDRESS:22699 KINROSS LANETELEPHONE:
(951) 419-0024
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92557
CAPACITY:6CENSUS: 3DATE:
03/19/2026
UNANNOUNCEDTIME BEGAN:
12:06 PM
MET WITH:NKechi AnwuliTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Licensee not maintaining records
Licensee not adhering to client needs
INVESTIGATION FINDINGS:
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On March 19, 2026, the Department of Social Services staff conducted an unannounced visit to this facility to continue investigation of the above allegations and to deliver findings. The Department was met by Keyna Eze Direct Service Professional (DSP) and Subsequently, Administrator NKechi Anwuli arrived, and the purpose of the visit was explained.

Investigation consisted of the following:
On November 15, 2023, the Department conducted an unannounced initial visit to the facility to investigate the complaint allegation mentioned above. During the visit, it was determined that the complaint required further investigation.

On March 19, 2026, the Department obtained staff roster (dated: 3/1/26), client roster (dated 3/1/26), C1’s medical Visit Record (dated 9/16/23), Physician’s follow up visit report (dated 10/17/23), The department interviewed Administrator (A1), and 2 staff (S1-S2), and 2 clients (C2-C3)
Page 1 of 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
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-20231114082903
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: GRACE VILLA
FACILITY NUMBER: 331800157
VISIT DATE: 03/19/2026
NARRATIVE
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The investigation revealed the following:

Allegation: Licensee not maintaining records

The detail of complaint alleges that Licensee is not maintaining accurate medication records as medication was given but not “signed off on” for several identified dates in November 2023.

On March 19, 2026, at 2:30pm, the Department interviewed Administrator (A1) , who denied the allegation stating that they maintain their records well, and there has been no report of medication errors of any kind.

On March 19, 2026, between 2:18pm and 4pm the Department interviewed 2 staff (S1-S2) regarding the allegation and of those interviewed 2 out of 2 staff denied the allegation stating that they have received medication training and they properly document the medication given. Each staff have Direct Service Professional (DSP) 1 and 2 training which includes medication certification.

On March 18 and 19 2026 the Department made call attempts to speak with the Placement Agency’s Quality Assurance Specialist (W1). However, calls were not returned by time of visit.

The Department reviewed the current MAR (March 2026) and found no discrepancies. All medication was given and signed off on.

Not all records from 2023 were available for the Department to review.

Based on the information gathered, there is insufficient evidence to support the allegation mentioned above; Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20231114082903
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: GRACE VILLA
FACILITY NUMBER: 331800157
VISIT DATE: 03/19/2026
NARRATIVE
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Allegation: Licensee not adhering to client needs

The detail of the complaint alleges that C1’s doctor recommended that C1 be referred to a specialist for dental care and care provider has not followed up.

On March 19, 2026, at 2:30pm, the Department interviewed Administrator (A1), who denied the allegation and stated that "we tend to all the client's needs, and follow any and all recommendations from the doctor."

On March 19, 2026, between 2:18 pm and 4pm the Department interviewed 2 staff (S1-S 2) regarding the allegation and of those interviewed 2 out of 2 staff denied the allegation stating that they meet the needs of the clients in care and follow all orders and recommendations.

On March 18 and 19 2026 the Department made call attempts to speak with the Placement Agency’s Quality Assurance Specialist (W1). However, calls were not returned by time of visit.

Not all records from 2023 were available for the Department to review.

On March 19,2026, the Department observed that the clients were well groomed and had good hygiene. 2 out of 3 clients stated that they are treated well. 1 out 3 is non-verbal.

Based on the information gathered, there is insufficient evidence to support the allegation mentioned above; Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

There were no deficiencies cited during today's visit. Exit interview conducted and copy of report provided.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3