<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800223
Report Date: 07/06/2026
Date Signed: 07/06/2026 03:35:48 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
06/26/2026 and conducted by Evaluator Janira Arreola
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20260626152157
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: 89DATE:
07/06/2026
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Business Office Manager, Nicole KalacasTIME COMPLETED:
03:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not provide resident records to the resident's authorized representative.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Janira Arreola, conducted an unannounced visit to the facility in order to deliver findings for the above allegation. LPA met with Business Office Manager, Nicole Kalacas who was informed of the purpose of the visit. The investigation consisted of interviews and records review.

Staff did not provide resident records to the resident's authorized representative.

It was alleged that Resident #1's (R1) Responsible Party (RP) requested discharge records following R1's discharge from the facility on 06/15/2026 and had not received them.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 07/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2026
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-20260626152157
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: 07/06/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA interviewed RP, who stated she requested discharge paperwork from the facility on 06/15/2026 and again around 06/20/2026. RP alleged as of 07/02/2026, RP had not received documentation needed to verify R1's discharge date.

LPA interviewed (3) staff members who stated RP was provided with requested discharge records such as a medications list and a refund check. (3) staff stated the facility had no record of a request for additional records prior to RP's email dated 06/29/2026. Email correspondence was reviewed and revealed facility staff responded on 06/29/2026 requesting clarification regarding the records being requested. (1) of (3) Staff stated that on 07/01/2026, following a telephone call from a county representative on behalf of RP, clarification was provided to facility staff on what records RP was requesting. (1) Facility staff stated additional information was provided to the county representative for relay to RP on how to request records with R1’s discharge date.

Based on interviews and records reviewed, the allegation is Unsubstantiated. 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.

SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 07/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2