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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880725
Report Date: 07/10/2024
Date Signed: 07/10/2024 02:32:47 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
07/02/2024 and conducted by Evaluator Janira Arreola
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240702120828
FACILITY NAME:TEMPLE HEIGHTSFACILITY NUMBER:
331880725
ADMINISTRATOR:HOBBS, ESTAFACILITY TYPE:
740
ADDRESS:26707 PADDINGTON CTTELEPHONE:
(951) 640-2606
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY:6CENSUS: 5DATE:
07/10/2024
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Staff, Mauhammad AlviTIME COMPLETED:
02:40 PM
ALLEGATION(S):
1
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9
Staff are dispensing resident pills a week in advance
INVESTIGATION FINDINGS:
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2
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13
Licensing Program Analyst (LPA) Janira Arreola, conducted an unannounced visit to the facility in order to investigate the above allegation. LPA met with Staff, Mauhammad Alvi, LPA conducted interviews and conducted a walk through.

It was alleged that staff prepare medication (1) week in advanced for the facility residents. LPA conducted a walk through and inspection of the resident medications and the facility and observed no prepoured medications. LPA conducted (2) staff interviews who confirmed medications are not prepoured for residents. 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.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024
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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