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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880545
Report Date: 04/11/2026
Date Signed: 04/11/2026 02:00:58 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
08/09/2023 and conducted by Evaluator Tena Herrera
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20230809120434
FACILITY NAME:MAC'S HOME #1FACILITY NUMBER:
331880545
ADMINISTRATOR:PETERS, STEPHANIEFACILITY TYPE:
735
ADDRESS:887 ARIA RDTELEPHONE:
(951) 305-6288
CITY:HEMETSTATE: CAZIP CODE:
92543
CAPACITY:4CENSUS: 1DATE:
04/11/2026
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Lance Peters - LicenseeTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Facility does not have adequate food supply
Staff threatened resident
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced subsequent complaint visit to investigate the above allegation. LPA arrived at facility at approximately 11:15am, there was no one at the facility, LPA called numbers found in database and got a returned call from Licensee Lance Peters, LPA explained the purpose of todays visit and Licensee Lance Peters arrived at the facility at 1:45pm.

The investigation consisted of the following:

LPA toured kitchen, inspected food supply, obtained copy of the food menu, and conducted interviews with 4 Staff (S1-S4), 1 Client (C2), and 1 Witness (W1). Interview with C1 was not conducted as they are no longer a client at the facility.

(Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2026
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-20230809120434
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: MAC'S HOME #1
FACILITY NUMBER: 331880545
VISIT DATE: 04/11/2026
NARRATIVE
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Allegation: Facility does not have adequate food supply
It is alleged that the facility does not maintain adequate food supply for the clients in care. . LPA obtained a copy of the Food Menu and toured kitchen, LPA observed a sufficient amount of both perishable and non-perishable food supply. LPA interviewed 4 staff and each denied the allegation stating there is always sufficient food at the facility, groceries are purchased either weekly or biweekly depending on the need. Since the facility only has one client at the time who goes on home visits often, food is purchased accordingly to meet the needs of the client and to avoid spoilage of the perishable food supply. LPA interviewed 1 Client and client denied the allegation and stated that there is always food and snacks at the facility. LPA interviewed 1 Witness and they denied the allegation and stated this has never been a concern of theirs since C1 has lived at the facility and that C1 has never expressed that there is low food supply or that they are left hungry.

Allegation: Staff threatened resident
It is alleged that staff would threaten C1 with eviction if they did not turn over their food stamps. LPA interviewed 4 Staff and each denied the allegation, S2-S4 stated they have never heard of any clients having food stamps and that the facility purchases the food for the clients with facility funds. Interview with S1 revealed that C1 was receiving food stamps for a short period of time, which is unusual since all clients are serviced through Regional Center and none of the other clients have ever had food stamps, S1 spoke to C1’s case worker about this concern and the case worker took care of the mix up, S1 confirmed that staff never took any of the funds from C1 and whatever food stamps C1 did have was discussed between the client and their case worker. LPA interviewed 1 Client and client denied ever being threatened by staff. LPA interviewed 1 Witness and they denied ever observing staff threaten clients and they stated that C1 has never received food stamps.

Based on statements and interviews conducted with staff & clients, review of facility file records, and LPA’s observations, there was not enough supportive evidence to concur with the reported allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview held, and a copy of this report was provided.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2026
LIC9099 (FAS) - (06/04)
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