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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800223
Report Date: 05/21/2025
Date Signed: 05/21/2025 11:18:37 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
05/31/2024 and conducted by Evaluator Janette Romero
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240531131008
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: 86DATE:
05/21/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Office Manager, Nicole AnguianoTIME COMPLETED:
11:25 AM
ALLEGATION(S):
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Staff do not ensure residents are provided nutritious meals.
Staff did not safeguard resident's personal belongings.
INVESTIGATION FINDINGS:
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On 5/21/2025, Licensing Program Analyst (LPA) Janette Romero made an unannounced visit to the facility to deliver findings regarding the allegation listed above. LPA met with Office Manager, Nicole Anguiano who was informed of the purpose of the visit.

Regarding the allegation, “Staff do not ensure residents are provided nutritious meals” it was alleged staff do not ensure Resident 1 (R1) receives a nutritious meal. LPA reviewed R1’s Identification and Emergency Information (LIC 601) dated 1/5/2024 noting R1 was admitted to the facility on 1/8/2024 and had a responsible person. LPA reviewed R1’s signed physician’s report dated 5/28/24 indicating R1 does not require a special diet and has a capacity to feed themselves. LPA reviewed the facility’s menu, which meets the Department’s general food service requirements. LPA conducted an interview with R1’s responsible person who corroborated the allegation and reported the facility frequently served a tuna sandwich or hot dog with chips for lunch. Administrator, Teresa Mapilis was interviewed and reported the following information. The facility hosts a birthday party for the residents every month and serves hot dogs, pizza, hamburgers, and sandwiches with fries or potato chips for lunch, which the residents really seem to enjoy.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025
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-20240531131008
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: 05/21/2025
NARRATIVE
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Fruits, vegetables, and salads are always available as side dishes during special celebrations. While residents may occasionally have hot dogs, pizza, hamburgers, or sandwiches for lunch, this should not be taken as indicative of residents’ overall nutritional intake at the facility. The facility follows their menu and serves balanced and nutritious meals unless a resident requests an alternative option. Residents with dietary requirements prescribed by their physician including gluten free, high protein, and low sodium are always accommodated to. Four (4) staff interviews conducted corroborated the information provided by Administrator Mapilis and added residents receive additional food and alternative menu options when requested.

Regarding the allegation, “Staff did not safeguard resident's personal belongings” it was alleged three (3) of R1’s bracelets have gone missing while residing in the facility. LPA reviewed R1’s Client/Resident Personal Property and Valuables (LIC 621) dated 1/5/2024 stating, “At the present time I decline to track personal property. I understand that I have the right to request a new copy of this form to start tracking personal property at any time.” The LIC 621 dated 1/5/2024 appeared to be electronically signed by R1’s responsible person and Administrator Mapilis. Administrator Mapilis reported R1’s responsible person did not request a new LIC 621 to request the facility begin tracking R1’s personal property. R1’s responsible person was interviewed and was unable to recall signing the LIC 621 requesting the facility to not track R1’s property. R1’s responsible person reported R1 wore three (3) bracelets that went missing while they resided in the facility. R1’s responsible person added only one (1) of three (3) bracelets were found. LPA reviewed an incident report dated 5/29/2024 noting one (1) bracelet was found and placed on R1 in the presence of their responsible person. The incident report also notes R1’s responsible person stated they felt bad taking the jewelry because it was R1’s identity. LPA reviewed a second incident report dated 6/2/2024 noting medical personnel provided the facility with a hospital bag which included the “jewelries” inside. The incident report notes R1’s responsible person was called to pick the “jewelries” and stated they would do so at a later time.

SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20240531131008
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: 05/21/2025
NARRATIVE
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OM Anguiano reported R1’s responsible person later picked up the two (2) missing bracelets. Three (3) of four (4) staff interviewed reported having knowledge R1’s bracelets were misplaced. Three (3) of four (4) staff interviewed reported the following information. A resident’s jewelry is removed before they shower to help protect it from damage that may be caused by soap or water. Care staff providing shower assistance to the resident is responsible for placing the jewelry back on the resident immediately after the shower. One (1) of three (3) of R1’s missing bracelets was found in R1’s drawer and provided to management due to reports of it missing. The two (2) remaining bracelets were provided in a bag by paramedics when R1 returned to the facility following a hospital stay. During the initial complaint visit, LPA attempted to conduct an interview with R1 and was informed R1 was not present in the facility. R1’s responsible person reported R1 was removed from the facility sometime in 2024 and is not available for an interview. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violations did or did not occur; therefore, the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to OM Anguiano.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3