331800223-8-22-2024-18-AS-CTUA-DVJ2U7-20260629174145

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331800223
Report Date: 08/22/2024
Date Signed: 08/22/2024 03:59:29 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
02/06/2024 and conducted by Evaluator Stephanie Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20240206101016

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: 91	DATE:	08/22/2024
		UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Nicole Anguiano, Business Office Manager		TIME COMPLETED:	04:10 PM

ALLEGATION(S):

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Staff are not showering resdients regularly
Staff was rough with a resident in care
Staff is rude to residents in care

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs), Stephanie Martinez and Ferrer Sabarias, conducted an unannounced visit to the facility to deliver the findings of the investigation into the above allegations. The LPAs met with Business Office Manager, Nicole Anguiano, and informed her of the purpose for the visit.

The investigation included resident and staff interviews, a review of records, and collection of relevant documentation.

A report was received by the Department alleging facility staff are failing to provide residents with showers that are scheduled to be provided two (2) times per week. Ten (10) interviews were conducted with residents who receive assistance to bathe; of the ten (10), three (3) residents reported showers are received regularly, five (5) residents reported being able to shower on their own or not knowing if they receive assistance to shower, and two (2) residents reported shower assistance is insufficient. One of the two (2) residents interviewed one reported they have not spoken with staff to request additional showers. Two (2) staff interviews were

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Stephanie Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

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-20240206101016

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: 08/22/2024

NARRATIVE

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conducted; one staff reported there was no knowledge of residents not being showered regularly, while the second interview reported residents are not showered regularly. Rounding Logs, where showers can be documented, did not provide definitive information. Therefore, due to inconsistent information, this allegation is deemed UNSUBSTANTIATED at this time.

A second report was also received alleging Staff One (S1) was rough with Resident One (R1) when the staff roughly removed the resident's sweater and roughly transferred the resident to their wheelchair. S1 was interviewed and denied the allegation. R1 was interviewed and denied the allegation. R1; however, is diagnosed with a condition which might affect their ability to recall. Therefore, due to insufficient information, this allegation is deemed UNSUBSTANTIATED at this time.

Another report was received by the Department alleging a staff member, Staff One (S1), is rude and will make inappropriate statements to residents in care. S1 was interviewed and denied the allegation. Ten (10) resident interviews were conducted; nine (9) residents denied the allegation. One resident who reported that staff are rude refused to provide additional information regarding the matter. Two (2) staff interviews were conducted; one (1) staff reported having no knowledge of staff being rude, while the other staff reported only hearing a complaint from a resident of an unknown staff member being rude to the resident. The resident identified was questioned and denied the allegation. Therefore, due to insufficient information, this allegation is deemed UNSUBSTANTIATED at this time.

A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

This report was reviewed with Business Office Manager Anguiano and a copy was provided.

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Stephanie Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

LIC9099 (FAS) - (06/04)

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