331881095-9-30-2025-18-AS-RORN-DM9NF5-20251008102458

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331881095
Report Date: 09/30/2025
Date Signed: 09/30/2025 11:48:10 AM

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
08/22/2022 and conducted by Evaluator Mary G Flores

COMPLAINT CONTROL NUMBER: 18-AS-20220822155330

FACILITY NAME:	IVY PARK AT MURRIETA		FACILITY NUMBER:	331881095
ADMINISTRATOR:	BORJA, JINA L.		FACILITY TYPE:	740
ADDRESS:	27100 CLINTON KEITH ROAD		TELEPHONE:	(951) 477-5678
CITY:	MURRIETA	STATE: CA	ZIP CODE:	92562
CAPACITY:	137	CENSUS: 121	DATE:	09/30/2025
		UNANNOUNCED	TIME BEGAN:	07:59 AM
MET WITH:	Karen Lovett - Business Office Director		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Resident does not have access to belongings
Staff are trying to remove resident from facility under false information
Resident is not accorded dignity in relationship with staff

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mary Flores conducted a subsequent complaint investigation visit regarding the above allegations. LPA met with Karen Lovett and explained the reason for the visit.

The investigation consisted of the following: On 8/24/22 LPA Mixson conducted an initial investigation visit. On 9/25/25 LPA Flores requested physician’s report, admissions agreement, needs and care plan, safeguard of personal property over the phone for resident #1. On 9/30/25 LPA Flores conducted a visit and interviewed 6 staff, 10 residents and toured 10 resident rooms.

The investigation revealed the following: Regarding allegation: Resident does not have access to belongings. It is alleged that a resident #1 does not have access to their belongings. Interviews with 8 out of 10 residents revealed residents have access to their personal belongings and do not have any concerns. 2 out of 10 residents were unable to be interviewed due to cognitive skills. (CONTINUED ON LIC 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2025

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-20220822155330

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: IVY PARK AT MURRIETA	FACILITY NUMBER: 331881095
	VISIT DATE: 09/30/2025

NARRATIVE

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Interviews with staff revealed residents have access to their personal belongings. In the memory care unit, residents have access to their clothes, briefs, toothbrush, comb/brush, etc. However, items that may cause harm, such as lotions, mouthwash, shampoo/conditioner, are locked in their personal cabinet and accessible when assisting with grooming. LPA toured 6 resident rooms in assisted living and 4 resident rooms in memory care and observed residents had their rooms decorated to their taste and personal belongings were accessible in their closets, dressers, and other furniture. In memory care LPA observed residents’ clothes and other personal belongings accessible. Lock cabinets were opened by staff and grooming items were observed in them. LPA was unable to interview resident #1as the resident no longer resides in the facility. Facility since has had a change in management and documents are currently stored at corporate level.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Regarding allegation: Staff are trying to remove resident from facility under false information. It is alleged facility staff have attempted to transfer resident #1 out of the facility under a false pretense. Interviews with 6 out of 10 residents revealed residents have been treated respectfully by staff and they are aware that if they have a change of condition, they will have to make different arrangements. 4 out of 10 residents were unable to be interviewed due to cognitive skills. Interviews with staff revealed residents are not asked to move out due to staff observation or residents’ behaviors. Per staff, residents are evaluated, and proper steps are taken. LPA was unable to interview resident #1 as the resident no longer resides in the facility. LPA was not able to review resident #1's file as the facility change management and files were surrender to corporate in 2024.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Regarding allegation: Resident is not accorded dignity in relationship with staff. It is alleged that resident #1 is being isolated by staff due to resident’s comments. Interviews conducted with residents revealed 8 out of 10 residents stated staff are respectful and treat residents accordingly. 2 out of 10 residents were unable to be interviewed due to cognitive skills.
(CONTINUED ON LIC 9099C)

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2025

LIC9099 (FAS) - (06/04)

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Control Number 18-AS-20220822155330

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: IVY PARK AT MURRIETA	FACILITY NUMBER: 331881095
	VISIT DATE: 09/30/2025

NARRATIVE

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Interviews with staff revealed staff communicate and act respectfully with residents and have not witnessed staff being disrespectful. Two staff stated to have heard a resident state to be uncomfortable with a resident for unknown reasons. LPA was unable to interview resident #1 as the resident no longer resides in the facility.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview was conducted with Krystal Jenkins Executive Director and a copy of this report was provided.

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2025

LIC9099 (FAS) - (06/04)

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