331880734-5-12-2026-18-AS-RORN-DUFUYA-20260526155936

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880734
Report Date: 05/12/2026
Date Signed: 05/12/2026 02:54:39 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
08/05/2024 and conducted by Evaluator Deborah Lee

COMPLAINT CONTROL NUMBER: 18-AS-20240805155833

FACILITY NAME:	RANCHO MIRAGE TERRACE		FACILITY NUMBER:	331880734
ADMINISTRATOR:	MONIQUE MOREIRA		FACILITY TYPE:	740
ADDRESS:	34560 BOB HOPE DRIVE		TELEPHONE:	(760) 770-7737
CITY:	RANCHO MIRAGE	STATE: CA	ZIP CODE:	92270
CAPACITY:	142	CENSUS: 109	DATE:	05/12/2026
		UNANNOUNCED	TIME BEGAN:	12:08 PM
MET WITH:	Nathan Boese		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility staff are not properly supervising residents who are a fall risk

INVESTIGATION FINDINGS:

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On May 12, 2026, the Department of Social Services staff conducted an unannounced visit to this facility to continue investigation of the above allegation and to deliver findings. The Department was met by Nathan Boese Executive Director and reason for visit explained
Investigation consisted of the following:
On August 12, 2024, the Department conducted an unannounced initial visit to the facility to investigate the complaint allegation mentioned above. During the visit, it was determined that the complaint required further investigation.
On May 12, 2026, the department conducted an unannounced visit to continue investigation of above allegations. The department obtained the following documentation: Staffing schedule (dated 5/12/26), Resident Roster (dated 5/12/26), R1’s facility incident reports (8/20/24, 8/2/24,7/27/24, 9/27/23), Change of conduction assessments (dated 5/14/24, 3/19/24, Hospital stay After visit summary (3/15/24), 3/12/24, 9/27/23) Physicians report LIC 602 (dated 10/4/22), Staff training on fall prevention (dated 3/20/25, 3/30/26, 12/22/24, 2/17/25) R1’s service plan (5/14/24) Suspected Elder abuse policy (various dates)
On May 12, 2026, the department conducted interview with Administrator (A1), 5 staff (S1-S5) and 4 Residents (R2-R5). R1 no longer lives at the facility.
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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

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-20240805155833

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: RANCHO MIRAGE TERRACE	FACILITY NUMBER: 331880734
	VISIT DATE: 05/12/2026

NARRATIVE

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The investigation revealed the following:

Allegation: Facility staff are not properly supervising residents who are a fall risk

The detail of the complaint alleges R1 have had multiple falls which may have been due to lack of proper supervision.

On May 12, 2026, at 12:15am the department interviewed Executive Director (A1), who was not with the facility during time of the complaint, however he was able to provide the department with documentation from that time frame. On issue of staff supervision, A1 added that they have adequate coverage to meet the residents need and if someone “calls out,” there is a plan in place to have the shift covered.

On May 12, 2026, between 12:40pm and 1:20pm the department interviewed 5 staff (S1-S5) regarding the allegation. Of those interviewed, 5 out of 5 denied the allegation stating that staff always provide proper supervision to the residents. 5 out of 5 stated that they have had training on fall prevention and it is refreshed frequently during in-service training/meetings. Additionally, 5 out of 5 staff state that there are enough staff to meet the residents’ needs. Lastly, the staff stated that they “work together as a team to get the job done.”

On May 12, 2026, the department interviewed 4 residents (R2-R5). Of those interviewed, 4 out of 4 stated that they are treated well and staff would help them if they needed. 2 out of 4 stated that they had a fall at the facility and staff were there to help them. Lastly, 3 out of 4 stated that they feel that there is enough staff to meet their needs. 1 out of 4 stated that there is not enough staff.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

LIC9099 (FAS) - (06/04)

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Control Number 18-AS-20240805155833

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: RANCHO MIRAGE TERRACE	FACILITY NUMBER: 331880734
	VISIT DATE: 05/12/2026

NARRATIVE

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On May 12, 2026, the department obtained and evaluated the following documents: R1’s facility incident reports (8/20/24, 8/2/24,7/27/24, 9/27/23), Change of condition assessments (dated 5/14/24, 3/19/24, Hospital After visit summaries (3/15/24, 3/12/24, 9/27/23) Physicians report (dated 10/4/22), Staff training on fall prevention (dated 3/20/25, 3/30/26, 12/22/24, 2/17/25) R1’s service plan (5/14/24), Suspected Elder abuse policy (various dates)

The documents reviewed showed the facility followed R1’s service plan and provided proper intervention after R1’s fall such as assessment, calling 911, notifying the responsible party (family), notifying the doctor. Additionally, the department observed that they documented each incident and follow up activities. Lastly, the facility completed change of condition assessments.

On May 12, 2026, the department observed the facility to be clean, safe and sanitary in addition to observing that there were sufficient staff attending to the residents at time of visit.

Based on the information gathered, there is insufficient evidence to support the allegation mentioned above; Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview conducted with the Executive Director. No deficiencies cited during today’s visit. Copy of report was provided.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

LIC9099 (FAS) - (06/04)

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