331880774-5-6-2026-18-AS-RORN-DU8UAC-20260519152431

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880774
Report Date: 05/06/2026
Date Signed: 05/06/2026 12:50:44 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
01/12/2024 and conducted by Evaluator Deborah Lee

COMPLAINT CONTROL NUMBER: 18-AS-20240112095238

FACILITY NAME:	RAINCROSS AT RIVERSIDE		FACILITY NUMBER:	331880774
ADMINISTRATOR:	JUDITH PIERFAX		FACILITY TYPE:	740
ADDRESS:	5232 CENTRAL AVENUE		TELEPHONE:	(951) 785-1200
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92504
CAPACITY:	120	CENSUS: 76	DATE:	05/06/2026
		UNANNOUNCED	TIME BEGAN:	09:54 AM
MET WITH:	Carlos Espino		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Facility staff do not safeguard resident's personal belongings,
Facility does not provide meal service to resident.
Facility staff do not assist resident with toileting.

INVESTIGATION FINDINGS:

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On May 6, 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 Carlos Espino and reason for visit explained
Investigation consisted of the following:
On January 19, 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 5, 2026, the department conducted an unannounced visit to continue investigation of above allegations. The department obtained the following documentation--a copy of theft and loss policy. The department needs to obtain additional information to render a finding, therefore the complaint requires further investigation.
On May 6, 2026, the department obtained R1’s Physician’s report (dated: 6/13/23), R1’s Physician’s orders (dated: 6/22/23), R1’s Admission Agreement (dated 6/11/23), personal rights (dated 6/14/23), R1’s care plan (dated 5/6/26) and Task Administration Record (dated April 2026). The department conducted interviews with Executive Director (A1), Caregiving staff (S1) and Resident (R1).
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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2026

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-20240112095238

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: RAINCROSS AT RIVERSIDE	FACILITY NUMBER: 331880774
	VISIT DATE: 05/06/2026

NARRATIVE

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The investigation revealed the following

Allegation: Facility staff do not safeguard resident's personal belongings,

The detail of complaint alleges when R1 the wakes up in the morning, her diapers, wipes, and other items have been stolen.

On May 6, 2026, at 11:00am, the department interviewed Executive Director (A1). A1 informed the department that he has only served that role for 1 month, so he was unable to provide any information regarding the complaint, however he provided the department with pertinent documents related to the complaint.

On 5/6/26, the department interviewed care giving staff (S1) who provides care for R1. S1 denied the allegation stating that R1 often fabricates, however R1 has never mentioned anything about missing items from her room to S1. All items are accounted for in R1’s room.

On January 19, 2024, the department interviewed R1 who didn’t mention anything about her personal belongings allegedly being stolen.

On January 19, 2024, the Department interviewed staff and the Executive Director at the time. Both denied the allegation, explaining that R1 has a history of reporting missing items from her room, but staff have not found anything to be missing. Staff also stated that the residents do not have roommates who receive visits from family members.

On May 6, 2026, the department interviewed R1 who did not mention anything about missing items.

On May 6, 2026, the department reviewed and evaluated the facility’s lost and theft policy.

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.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2026

LIC9099 (FAS) - (06/04)

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Control Number 18-AS-20240112095238

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: RAINCROSS AT RIVERSIDE	FACILITY NUMBER: 331880774
	VISIT DATE: 05/06/2026

NARRATIVE

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Allegation: Facility does not provide meal service to resident.

The detail of complaint alleges R1 must pay for all her meals out of pocket. R1 cannot afford to eat the meals there, so R1’s friends take her meals to help her

On May 6, 2026 at 11:00am, the department interviewed Executive Director (A1). A1 informed the department that he has only served that role for 1 month, so he was unable to provide any information regarding the complaint, however he provided the department with pertinent documents related to the complaint.

On January 19, 2024, interview conducted with Executive Director revealed that there is a tray service fee associated with having meals brought to the room and R1 allegedly didn’t want to pay that cost but wanted the service. This service is outlined in the admission agreement.

On May 6,2026, the department reviewed and evaluated the admission agreement signed by R1 and responsible party. The department observed the section of Admission Agreement called Schedule of Additional fees which indicated the Room/Tray Service fee is $10.00 per meal per apartment.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2026

LIC9099 (FAS) - (06/04)

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Control Number 18-AS-20240112095238

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: RAINCROSS AT RIVERSIDE	FACILITY NUMBER: 331880774
	VISIT DATE: 05/06/2026

NARRATIVE

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Allegation: Facility staff do not assist resident with toileting.

The detail of complaint alleges “staff makes R1 clean her own bottom when she is changed”

On May 6, 2026, the department interviewed care staff (S1) who denied allegation stating she and other staff assist R1 with all of her bathing/hygiene needs per her service plan and it is documented in Task Administration Record.

On January 19, 2024, the Department interviewed staff and the Executive Director at that time. They denied the allegation, explaining that R1 often requests an additional wipe after caregivers have finished cleaning her because she feels she is not fully clean and prefers to complete the task herself. Staff further reported that they would never require any residents to wipe themselves.

On May 6, 2026, the department reviewed and evaluated the R1’s service plan, and the Task Administration Record which includes R1’s scheduled showers, changing schedule and other tasks. Staff who performed the task are also listed.

Exit interview conducted with Carlos Espino. No deficiencies cited during today’s visit. Copy of report provided.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2026

LIC9099 (FAS) - (06/04)

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