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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880924
Report Date: 08/14/2024
Date Signed: 08/14/2024 09:17:36 AM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/13/2024 and conducted by Evaluator Venus Mixson
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240813130615
FACILITY NAME:CITRUS PLACEFACILITY NUMBER:
331880924
ADMINISTRATOR:VICKY TORRESFACILITY TYPE:
740
ADDRESS:7898 CALIFORNIA AVENUETELEPHONE:
(951) 687-2241
CITY:RIVERSIDESTATE: CAZIP CODE:
92504
CAPACITY:140CENSUS: 108DATE:
08/14/2024
UNANNOUNCEDTIME BEGAN:
07:43 AM
MET WITH:EXECUTIVE DIRECTOR, VICKY TORRESTIME COMPLETED:
09:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On August 14, 2024, Licensing Program Analyst (LPA), Venus Mixson arrived unannounced to initiate the investigation into the listed allegation pertaining to Personal Rights and met with Business Office Manager and explained the purpose of the visit.

During today's visit, LPA toured the facility, along with Nina Guzman and requested and received copies of pertinent documents related to Resident #1(R1). LPA was informed that R1 does not reside at the listed facility but resides at the Independent Community (Manor).

Due to Community Care Licensing not having jurisdiction over the listed facility this the allegation has been deemed "UNFOUNDED." Based on interviews, record reviews, and observations the allegation finding has been deemed "Unfounded." An allegation finding of "unfounded," means the allegation was without merit or is false and could not have happened and/or is without a reasonable basis.

There were No health and safety concerns observed during today's visit.
An exit interview was conducted, and a copy of this report was discussed and provided, along with LIC811- Confidential Names List, to Executive Director, Vicky Torres.

Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Jazmond D HarrisTELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Venus MixsonTELEPHONE: (951) 897-7936
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
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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