331800223-8-26-2026-18-AS-CTUA-DXSTW2-20260910150450

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331800223
Report Date: 08/26/2026
Date Signed: 08/26/2026 09:45:22 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
08/13/2026 and conducted by Evaluator Janira Arreola

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20260813162948

FACILITY NAME:	YORKSHIRE VILLAGE		FACILITY NUMBER:	331800223
ADMINISTRATOR:	TERESA MAPILIS		FACILITY TYPE:	740
ADDRESS:	26933 CORNELL ST		TELEPHONE:	(951) 658-1068
CITY:	HEMET	STATE: CA	ZIP CODE:	92544
CAPACITY:	100	CENSUS: 85	DATE:	08/26/2026
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Business Office Manager, Nicole Kalacas		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Staff refused to provide assistance resulting in resident being left on the floor for an extended period of time.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Janira Arreola, conducted an unannounced visit to the facility in order to investigate the above allegations. LPA met with… who was informed of the purpose of the visit. During the visit, LPA conducted interviews, documented observations/conducted a walk through, and conducted records review.

“Staff refused to provide assistance resulting in resident being left on the floor for an extended period of time.”

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026

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-20260813162948

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: YORKSHIRE VILLAGE	FACILITY NUMBER: 331800223
	VISIT DATE: 08/26/2026

NARRATIVE

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It was alleged that on 08/12/2026, the Fire Department received a call for medical assistance after Resident #1 (R1) experienced a fall. It was alleged R1 reported having a fall in the bathroom and was down for 15 minutes. R1 yelled out to staff for help and staff refused to assist R1 up from the ground. R1 crawled to the bathroom sink and was able to lift themselves to their knees. It was alleged that staff reported per facility policy, staff cannot assist when a resident has a fall. R1 was transported to the hospital.

LPA attempted to contact first responders on scene however, they were unavailable for interview.

LPA attempted to conduct an interview with R1, however R1 was not oriented during the interview.

LPA reviewed the facility incident report for 08/12/2026, which revealed S1 had assisted R1 on 08/12/2026 after experiencing an unwitnessed fall.

S1 reported R1 experienced an unwitnessed fall in another residents room, Resident #2 (R2)’s room. S1 had gone into R2’s room to assist R2 and observed R1 was wandering in the hallway. S1 estimated 15 minutes later at around 9:15pm/ 9:10pm staff conducted their rounds and observed R1 lying flat on the floor on top of a fall mat. S1 stated R1 reported pain all over their body and back and reported hitting their toe on a dresser in R2’s room.

S1 did not move R1 from the floor because S1 did not know if R1 was injured. S1 explained R1 is the type of resident to stub their toe and keep moving, and their expression of pain concerned them. S1 called 911 for R1. S1 denied that staff refused to provide assistance to R1. Regarding R1 being on their knees in a bathroom, S1 stated paramedics stayed with R1 in the room and when S1 returned they observed R1 was on their knees. S1 did not know how R1 got onto their knees.

SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 18-AS-20260813162948

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: YORKSHIRE VILLAGE	FACILITY NUMBER: 331800223
	VISIT DATE: 08/26/2026

NARRATIVE

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LPA reviewed facility video surveillance placed in the East Hallway outside of R2’s room on 08/12/2026. At 8:55 P.M. a staff member exits R2’s room. Approximately one minute later, R1 is seen entering R2’s bedroom. At 9:00 P.M. staff re-enters R2’s room and calls S1 for assistance. The video surveillance did not capture the interior of R2's room or fall.

LPA reviewed the facility call logs for 08/12/2026 which confirmed a call was made to 911 on 08/12/2026 at 9:03 P.M.

LPA attempted to interview R2, however they were not alert or oriented.

Interview with S1 and (2) management staff reported the facility training instructs care staff to not move residents off the floor when they experience unwitnessed falls due to the possibly of injuring or worsening a resident’s injury. Staff will call 911 to assess the resident. LPA reviewed Procedure for Falls in-service training conducted on 05/20/2026 which stated “If a resident has a fall do not move the resident. Wait until 911 arrives to properly assess resident.”

Based on interviews, and records reviewed the allegation was found to be unsubstantiated. Findings that are unsubstantiated mean the preponderance of the evidence standard has not been met. An exit interview was conducted where this report was reviewed and provided.

SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026

LIC9099 (FAS) - (06/04)

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