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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800223
Report Date: 07/15/2021
Date Signed: 07/15/2021 02:17:49 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/09/2021 and conducted by Evaluator Stephanie Williams
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20210709103434
FACILITY NAME:YORKSHIRE VILLAGEFACILITY NUMBER:
331800223
ADMINISTRATOR:KNOOP, BENITAFACILITY TYPE:
740
ADDRESS:26933 CORNELL STTELEPHONE:
(951) 658-1068
CITY:HEMETSTATE: CAZIP CODE:
92544
CAPACITY:100CENSUS: 71DATE:
07/15/2021
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Theresa MapilisTIME COMPLETED:
02:20 PM
ALLEGATION(S):
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Staff not allowing resident to leave facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Stephanie Williams conducted an unannounced visit to the facility in order to initiate a complaint investigation into the above allegation. LPA identified herself and met with Administrator, Theresa Mapilis, and discussed the purpose of the visit. The investigation consisted of interviews with staff and residents and records review.

LPA interviewed Resident #1 (R1) who stated that they have not attempted to leave the facility grounds due to not having anywhere to go or having a car. R1 stated that they are able to leave the facility; however, R1 has no finances or a place to go. R1 stated that they have a Public Guardian who placed R1 at the facility and handles R1's finances. LPA interviewed Resident #2 (R2) who stated that they are able to come and go as they please. LPA interviewed Staff #1 (S1) and Staff #2 (S2) who denied that staff is not allowing residents to leave the facility. S1 and S2 stated that they are accommodating to R1's request to leave the facility to go to the store. S1 and S2 denied that R1 has been attempting to leave the facility but rather requesting to live more independently. Due to R1's interview and lack of evidence to corroborate the allegation, the allegation is
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 248-0337
LICENSING EVALUATOR NAME: Stephanie WilliamsTELEPHONE: (951) 248-0317
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
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 2
Control Number 18-AS-20210709103434
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: YORKSHIRE VILLAGE
FACILITY NUMBER: 331800223
VISIT DATE: 07/15/2021
NARRATIVE
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unsubstantiated.

Based on evidence obtained during today’s visit, LPA has determined that the above allegation is UNSUBSTANTIATED; meaning that 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.

An exit interview was conducted where this report was discussed and a copy was provided to Mapilis.

SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 248-0337
LICENSING EVALUATOR NAME: Stephanie WilliamsTELEPHONE: (951) 248-0317
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2