331800223-5-22-2024-18-AS-APAO-DKS5S7-20250821201216

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331800223
Report Date: 05/22/2024
Date Signed: 05/22/2024 04:02:22 PM

Unfounded

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
05/14/2024 and conducted by Evaluator Yolanda Delgado

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20240514110222

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: 90	DATE:	05/22/2024
		UNANNOUNCED	TIME BEGAN:	10:06 AM
MET WITH:	Teresa Mapilis, Administrator		TIME COMPLETED:	02:50 PM

ALLEGATION(S):

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Illegal eviction

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Yolanda Delgado made an unannounced visit to the facility to investigate a complaint regarding the allegation listed above. LPA met with Administrator, Teresa Mapilis and explained the purpose of the visit and the elements of the allegation. LPA Delgado conducted the investigation which consisted of interview with staff member and record review.
On May 14, 2024, Community Care Licensing received a complaint stating illegal eviction. The allegation stated that the facility wrongfully evicted Resident #1 (R1), facility accused R1 of incorrect information, R1 threatened and harassed the other residents, R1 received a 30-day written notice. During the LPA’s investigation, LPA attempted 3 times to contact R1 with no return calls received.
(Continued on Page 2)

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Yolanda Delgado
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024

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-20240514110222

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: 05/22/2024

NARRATIVE

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(Continued from Page 1)

LPA reviewed R1’s face sheet, LIC602, Needs and Services plan, admission packet, assessment forms, progress notes, documentation of incidents that involved R1’s behavior with Administrator, staff and residents on separate dates from February 4, 2023 through January 4, 2024 with physical and verbal abuse towards other residents and staff. During the LPA’s interview with Administrator, it was concluded that Administrator hand delivered and mailed the eviction notice with a 30-Day notice along with several resources to help find alternate housing.

Based on LPAs observations, records review, and staff interview, this agency has investigated the complaint alleging “illegal eviction” and 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, LIC811 was provided to facility representative.

*LPA was away from the facility from 12:25-1:25PM

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Yolanda Delgado
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024

LIC9099 (FAS) - (06/04)

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