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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800223
Report Date: 08/12/2024
Date Signed: 08/12/2024 02:44:32 PM

Unfounded


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
03/08/2024 and conducted by Evaluator Sara Martinez
COMPLAINT CONTROL NUMBER: 18-AS-20240308165256
FACILITY NAME:YORKSHIRE VILLAGEFACILITY NUMBER:
331800223
ADMINISTRATOR:TERESA MAPILISFACILITY TYPE:
740
ADDRESS:26933 CORNELL STTELEPHONE:
(951) 658-1068
CITY:HEMETSTATE: CAZIP CODE:
92544
CAPACITY:100CENSUS: 88DATE:
08/12/2024
UNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Eloisa Mireles - Wellness DirectorTIME COMPLETED:
02:50 PM
ALLEGATION(S):
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9
Staff verbally abuse resident
Staff physically abused resident
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Sara Martinez arrived unannounced to the facility to conclude the investigation into the allegation listed above. LPA met with Wellness Director Eloisa Mireles and explained the purpose of the visit. The complaint investigation consisted of a tour of the interior/exterior areas of the facility, observations, interviews with staff and residents, and records review of requested pertinent documents.

Regarding the allegation “Staff verbally abuse resident” it was reported staff was verbally aggressive to Resident One (R1). Interview with R1 reveled it was not staff who was being verbally aggressive to R1 but Resident Two (R2). Interviews with staff and residents denied staff being verbally aggressive to residents and denied witnessing staff being verbally aggressive to R1 while in care.

Regarding the allegation “Staff physically abused resident” it was reported staff had grabbed R1 by the arm and pulled R1. Interview with R1 revealed it was not staff who had grabbed and pulled R1 but R2.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Tricia DanielsonTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Sara MartinezTELEPHONE: (951) 605-0913
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024
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 4
Control Number 18-AS-20240308165256
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: 08/12/2024
NARRATIVE
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Interviews with staff and residents denied staff being physically abusive to residents and denied witnessing staff being physically abusive to R1 while in care.

This agency has investigated the complaint alleging “Staff verbally abuse resident “ and “Staff physically abused resident”. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. An exit interview was conducted, and a copy of this report was provided to Wellness Director Eloisa Mireles.
SUPERVISOR'S NAME: Tricia DanielsonTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Sara MartinezTELEPHONE: (951) 605-0913
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
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
03/08/2024 and conducted by Evaluator Sara Martinez
COMPLAINT CONTROL NUMBER: 18-AS-20240308165256

FACILITY NAME:YORKSHIRE VILLAGEFACILITY NUMBER:
331800223
ADMINISTRATOR:TERESA MAPILISFACILITY TYPE:
740
ADDRESS:26933 CORNELL STTELEPHONE:
(951) 658-1068
CITY:HEMETSTATE: CAZIP CODE:
92544
CAPACITY:100CENSUS: 88DATE:
08/12/2024
UNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Eloisa Mireles - Wellness DirectorTIME COMPLETED:
02:50 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not safeguard resident's belongings
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Sara Martinez arrived unannounced to the facility to conclude the investigation into the allegation listed above. LPA met with Wellness Director Eloisa Mireles and explained the purpose of the visit. The complaint investigation consisted of a tour of the interior/exterior areas of the facility, observations, interviews with staff and residents, and records review of requested pertinent documents.

Regarding the allegation “Staff did not safeguard resident's belongings”, it was reported Resident One (R1) had items missing in their room when they returned to the facility after being hospitalized in September 2023. LPA conducted an interview with R1 who reported they were missing money, approximately $3, a juicer with a value of $50.00, and an unopened pack of underwear. R1 reported they had notified Staff One (S1) of the missing items. Records review of LIC 621 Client/Resident Personal Property and Valuables reveal R1 declined to have facility track personal property that is signed and dated by R1 on 09/11/2023. Records review of a signed document on 04/03/2024 had a list of R1’s items that were retrieved from R1’s room after ending their residency at the facility that included “five (5) pairs underwear”.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Tricia DanielsonTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Sara MartinezTELEPHONE: (951) 605-0913
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 18-AS-20240308165256
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: 08/12/2024
NARRATIVE
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Interview with two (2) out of four (4) residents revealed they were aware of a former resident who lived in building D who had allegedly stolen R1’s belongings. Interview with Resident Two (R2) reported they had their a few of their personal belongings and their tablet stolen by the former resident. Interview with five (5) out of five (5) staff revealed they were not aware of R1’s personal belongings being stolen. Interview with Staff One (S1) revealed R1 did not report to S1 they had their personal belongings stolen after their hospitalization in September 2023. Therefore due to insufficient information available, the allegation has been deemed unsubstantiated at this time. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to Wellness Director Eloisa Mireles.
SUPERVISOR'S NAME: Tricia DanielsonTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Sara MartinezTELEPHONE: (951) 605-0913
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 4