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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800160
Report Date: 04/10/2025
Date Signed: 04/10/2025 12:27:26 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
02/03/2021 and conducted by Evaluator Mary Rico
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20210203142919
FACILITY NAME:HIGHGATE SENIOR LIVING-TEMECULAFACILITY NUMBER:
331800160
ADMINISTRATOR:WILLIAMS, KATHLEENFACILITY TYPE:
740
ADDRESS:42301 MORAGA ROADTELEPHONE:
(951) 308-1885
CITY:TEMECULASTATE: CAZIP CODE:
92591
CAPACITY:99CENSUS: 87DATE:
04/10/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH: Assisted Living Coordinator (ALC), Melissa VillafanaTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Resident not assisted with the administration of medication.
Food service inadequate.
The resident contract is not adhered to.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to investigate and deliver findings on the allegations listed above. LPA met with Assisted Living Coordinator (ALC), Melissa Villafana and explained the purpose of the visit. The investigation consisted of staff interviews, resident interviews, record review and facility tour.

For the allegation, Resident not assisted with the administration of medication.

During staff interview, 6 out of the 6 staff informed LPA that residents are assisted with their medication. During resident interviews, 4 out of the 7 residents stated staff will assist with their medications. In addition, 3 out of the 7 residents stated they manage their own medications.

During medication audit, LPA Rico verify resident’s medication have been dispense properly along with documentation.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 04/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2025
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-20210203142919
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: HIGHGATE SENIOR LIVING-TEMECULA
FACILITY NUMBER: 331800160
VISIT DATE: 04/10/2025
NARRATIVE
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For allegation, food service inadequate.

During staff interviews, 6 out of the 6 staff stated the facility has adequate food available for residents. In addition, 6 out of the 6 staff informed LPA that the facility has a variety of food options for residents to select. During resident interviews, 7 out of the 7 residents stated the food service is adequate and is provided in a timely manner.

During facility tour and record review, LPA Rico observed the facility had variety of food available for residents. In addition, the facility also has a food menu posted along with options for residents to select.

For the allegation, the resident contract is not adhered to.

During staff interviews, 3 out of the 6 staff stated residents’ contract is adhered to, no changes are made without resident and their responsible party consent.

Based on the evidence found during the investigation, the three (3) allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.

An exit interview was conducted, and this report (LIC9099) was discussed and provided to Assisted Living Coordinator (ALC), Melissa Villafana .

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 04/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2025
LIC9099 (FAS) - (06/04)
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