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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881130
Report Date: 12/11/2025
Date Signed: 12/11/2025 01:30:13 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
04/03/2024 and conducted by Evaluator Deborah Lee
COMPLAINT CONTROL NUMBER: 18-AS-20240403160351
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: 6DATE:
12/11/2025
UNANNOUNCEDTIME BEGAN:
08:54 AM
MET WITH:Christian CourtTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Facility staff are not giving medication as prescribed.
INVESTIGATION FINDINGS:
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On December 11, 2025, the Department of Social Services staff conducted an unannounced visit to this facility to continue investigation of the above allegations and to deliver findings. The Department was met by Christian Court, Administrator and the purpose of the visit was explained.
Investigation consisted of the following:
On April 9, 2024, the Department conducted an unannounced initial visit to the facility to investigate the complaint allegations mentioned above. During the visit, it was determined that the complaint required further investigation.
On December 10, 2025 the Department requested and obtain the following documents: Staff roster (dated: 6/22/25), Client Roster (dated: 10/23/24), staff training on client’s Rights (dated 8/28/25, 2/25/25), Staff medication training (dated: 8/28/25), Medication Administrator Record (MAR) for April 2024, Centrally Store Medication and destruction sheet (dated 3/27/24), C1’s Physician’s report (dated: 7/28/22), and C1’s Needs and Services Plan (dated: 10/7/21), Pre-placement appraisal (dated 11/1/21) The Department conducted interviews with 2 staff (S2-S3 ) and Administrator (A1). The Department interviewed 3 clients (C2-C4 ).
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Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2025
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-20240403160351
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: 12/11/2025
NARRATIVE
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The investigation revealed the following:

Allegation: Facility staff are not giving medication as prescribed

The detail of the complaint alleges that house manager (S1) gave C1 an unfamiliar pill during the administration of medication, and when asked what it was, the S1 allegedly didn’t know.

On December 10, 2025, at 11:30am, the Department interviewed Christian Court (A1) who denied the allegation stating that there have been no reports of clients getting wrong medication. A1 further stated that all staff are trained in medication administration. Lastly, A1 reports that there have been no medication errors to date.

On December 10, 2025, between 11:30pm and 12:30pm, the Department interviewed 2 staff (S2-S3 ) regarding the allegation. Of those interviewed, 2 out of 2 denied stating that they have never given clients the wrong medication nor have they witnessed any other staff giving a client the wrong medication. 2 out of 2 stated that they have had medication training.

On December 10, 2025, between 12:30pm and 1:30pm the Department interviewed 3 clients (C2-C4). The Department could not interview C1 as C1 no longer lives at the facility as of 4/7/24. Of those interviewed, 3 out of 3 stated that they receive their medication on time and have never been given the wrong medication. 2 out of 3 stated that they know what their medication looks like, and 1 out of 3 weren’t sure about his medication. 2 out of 3 state that a staff explain to them if there has been a change to the medication, such as shape, color and dosage.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20240403160351
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: 12/11/2025
NARRATIVE
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On December 10, 2025, the Department reviewed and evaluated the following documents: C1’s Centrally Store Medication and Destruction sheet (dated 3/27/24), Pharmacy medication order for C1 (dated 5/1/24). The department observed that there were no inconsistencies.

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.

There were no deficiencies cited during today’s visit.

Exit interview conducted with Administrator and copy of report provided.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2025
LIC9099 (FAS) - (06/04)
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