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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881130
Report Date: 11/06/2025
Date Signed: 11/06/2025 01:08:20 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
10/26/2021 and conducted by Evaluator Antonine Richard
COMPLAINT CONTROL NUMBER: 18-AS-20211026130942
FACILITY NAME:C & M COMFORT HOMEFACILITY NUMBER:
331881130
ADMINISTRATOR:COURT, CHRISTIANFACILITY TYPE:
735
ADDRESS:24662 MANTEE PLACETELEPHONE:
(951) 378-5820
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY:6CENSUS: 5DATE:
11/06/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:COURT CHRISTIANTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Facility is denying resident access to health care services.
INVESTIGATION FINDINGS:
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On November 6, 2025, at 9:00 a.m., Licensing Program Analyst (LPA) Antonine Richard conducted a subsequent visit and delivered findings. LPA met with Administrator Christian Court and explained the purpose of the visit.
The investigation consisted of the following: On November 6, 2025, LPA Richard requested and obtained the residents' and staff roster, Physician reports, and the facility's Emergency and Disaster Plan for a Resident Care Facility for the Elderly (dated July 7, 2025). Unusual Incident/Injury Report (dated October 21, 2021), and Facility noted (dated October 21, 22, 2021). LPA interviewed the Administrator (A1), one staff member (S1), and four clients (C2-C5). LPA interviewed the responsible party (W1). LPA was unable to interview C1 because C1 no longer resides at the facility. On November 4, 2021, Licensing Program Analyst (LPA) Yolanda Delgado made an unannounced visit to the facility to initiate an investigation into the allegation listed above. LPA met with Care Provider Cecilia Egbune. LPA interviewed two (2) staff members and four (4) residents, requested and obtained copies of pertinent documentation, and toured the facility.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 18-AS-20211026130942
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: C & M COMFORT HOME
FACILITY NUMBER: 331881130
VISIT DATE: 11/06/2025
NARRATIVE
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Allegation: The facility is denying resident access to healthcare services.

The complaint alleged that the facility denied the client a healthcare visit while the client was hospitalized. On November 6, 2025, at 10:00 a.m., LPA Richard interviewed the Administrator (A1), who denied the allegation, stating that it was impossible to deny resident healthcare services when they were the ones who called Emergency Medical Services (EMS) to transport C1 to the emergency room. A1 insisted that the allegation was incorrect.

At approximately 10:30 a.m. on the same day, LPA interviewed a staff member (S1), who also denied the allegation, asserting that whenever a client requires EMS, they immediately call 911 to ensure the client receives proper care. Additionally, LPA interviewed four clients #2-5 (C2-C5), all of whom denied that the facility had denied their family access to them while they were in the hospital. They also stated that the facility had never denied them access to healthcare services when they needed it.

At approximately 10:30 a.m. on November 6, 2025, LPA interviewed the responsible party of C1 (W1), who denied the allegation. W1 expressed gratitude that the facility was teaching C1 how to call EMS (911) and emphasized that while calling 911 is helpful, C1 should not abuse the system. W1 also mentioned that C1 had been with the Licensee for an extended period at a different facility and required a higher level of care. This is why they moved C1 to the new facility as soon as the Administrator (A1) obtained the License. W1 concluded by expressing their trust in A1, affirming that A1 cares for C1's well-being.

Report continued on LIC9099C

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20211026130942
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: C & M COMFORT HOME
FACILITY NUMBER: 331881130
VISIT DATE: 11/06/2025
NARRATIVE
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On November 6, 2025, LPA reviewed the facility's unusual Incident/Injury Report (dated November 21, 2021), which indicated that the facility had notified all relevant agencies and individuals about the incident. At the same time, LPA reviewed the facility notes (dated October 21, 2021, and October 22, 2021), which indicated that the facility had been communicating with the hospital doctor, nurses, and pharmacy regarding the C1 hospitalization.

Based on the information collected from the facility, interviews, and records reviewed, LPA found no evidence to support the above allegations. Although the allegations may be valid or have occurred, there is insufficient evidence to establish whether the alleged violations took place or did not. Therefore, the allegation is unsubstantiated.

No deficiencies cited.

An exit interview was conducted. A copy of this report was provided to the Administrator, Christian Court.

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3