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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881201
Report Date: 08/19/2025
Date Signed: 09/26/2025 02:51:17 PM

Substantiated


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
08/07/2025 and conducted by Evaluator Janira Arreola
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20250807113043
FACILITY NAME:CONCEPT FOR LIFE HOME LLCFACILITY NUMBER:
331881201
ADMINISTRATOR:DUPREE, TIFFANYFACILITY TYPE:
735
ADDRESS:25791 FIR AVETELEPHONE:
(323) 921-8391
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY:4CENSUS: 4DATE:
08/19/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Staff Maria MedinaTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff speaks inappropriately to resident
Staff are not treating residents equally
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Janira Arreola, conducted an unannounced visit to the facility in order to investigate the above allegations. LPA met with Staff Maria Medina, who was informed of the purpose of the visit. During the visit, LPA conducted interviews, documented observations/conducted a walk through, and conducted records review.

It was alleged that “Staff are not treating residents equally.” It was alleged staff favor Client #1 (C1) and treat clients differently at the facility. LPA conducted (2) client interviews who revealed C1 is favored due to Staff #1 (S1) blocking clients from making phone calls for assistance. (1) client revealed they have to use C1’s phone to call S1 since C1 is not blocked by S1. (1) client revealed text messages where S1 stated they are blocking the client. LPA verified the text messages were coming from S1’s phone number.
*This is an amended report
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
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 6
Control Number 18-AS-20250807113043
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: CONCEPT FOR LIFE HOME LLC
FACILITY NUMBER: 331881201
VISIT DATE: 08/19/2025
NARRATIVE
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It was also revealed by (1) client that S1 was told a visitor of C1 made them feel uncomfortable due to information that the visitor had previously abused C1, had yelled at staff and residents, and had stolen person items from a client at the facility. The client revealed staff told them to “deal with it”, and felt S1 favored C1 and felt dismissed when they continued to allow the visitor to come to the facility. Attempts were made to interview C1, however they were unavailable for interview. Text messages were provided which were verified by the LPA from S1 telling client to not “bother” staff when they expressed their concerns on C1’s visitor.

LPA interviewed (3) staff including S1, which revealed staff was unaware of any corroborating information that the visitor had abused C1, or stolen from a client at the facility. (3) staff revealed they continued to allow the visitor into the home due to C1’s personal rights to visitors. S1 denied favoring C1 and confirmed they have blocked clients and stated they believe they have that right are client are not entitled to their attention 24/7. Therefore, it was found that staff are displaying preferential treatment toward clients based on LPA observation, record review, and interview.

It was alleged that “Staff speaks inappropriately to resident.” It was alleged that on 08/07/2025 S1 sent Client #2 (C2) text messages saying they should move out of the facility, C2 had ruined their day due to having to come over to the facility because C2 is in other peoples business.

There were screen captured text messages provided to the LPA for review. The contact phone number sending the text messages and the text conversation was verified by the LPA in real time. Texts from S1 addressed to C2 stated “thanks a lot” for “the drama you cause”, “you ruined my day and I know I have to come over because your in people business”. S1 also texts “If you don’t like my house”, “ you’re welcome to move”, “please do”.

Interview with C2 revealed that S1 has been speaking to them in an inappropriate manner since January of 2025. S1 denied speaking inappropriately to C2 and confirm they sent the text messages above. S1 stated they believed they were not addressing C2 inappropriately as they did not curse, did not mean the statements in a negative way, and stated they have the right to tell clients when they are wrong and ruining their day.

SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 18-AS-20250807113043
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: CONCEPT FOR LIFE HOME LLC
FACILITY NUMBER: 331881201
VISIT DATE: 08/19/2025
NARRATIVE
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Therefore, the allegation that staff spoke inappropriately to C2 is substantiated. Based on LPA’s observations, interviews conducted, and records reviewed, the preponderance of evidence standard has been met. California Code of Regulations Title 22 is being cited on the attached LIC 9099 D. An exit interview was conducted, and a copy of this report appeal rights and deficiency page was provided.
SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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
08/07/2025 and conducted by Evaluator Janira Arreola
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20250807113043

FACILITY NAME:CONCEPT FOR LIFE HOME LLCFACILITY NUMBER:
331881201
ADMINISTRATOR:DUPREE, TIFFANYFACILITY TYPE:
735
ADDRESS:25791 FIR AVETELEPHONE:
(323) 921-8391
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY:4CENSUS: 4DATE:
08/19/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Staff Maria MedinaTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff are not providing adequate food service for residents
INVESTIGATION FINDINGS:
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It was alleged “Staff are not providing adequate food service for residents.” It was alleged staff only grocery shop once a month for food and not enough food is purchased to last the month. It was alleged bottled water, bread, butter, and milk run out before the end of the month and is not replenished until the following month. It was alleged clients had to drink tap water when bottled water ran out which was making them sick. LPA interviewed (3) clients. (2) of (3) clients revealed staff shop one to two times a month, and items such as bottled water, milk, condiments, and snack items run out. (2) Clients stated staff do not repurchase food until the following month and will sometimes order premade food when they are running out. (1) client stated bottled water runs out and they drink tap water which upsets their stomach. (1) of (3) clients stated that food does not run out and staff replace food when it does run out.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 18-AS-20250807113043
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: CONCEPT FOR LIFE HOME LLC
FACILITY NUMBER: 331881201
VISIT DATE: 08/19/2025
NARRATIVE
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LPA conducted (3) staff interviews who revealed staff shop twice a month and shop as needed if food items run out. Staff denied knowing residents got sick from drinking tap water. During the time of the visit on 8/13/2025 and 8/19/2025 the facility met the 2-day supply of perishable and 7-day supply of non perishable foods including bottled water, milk, and condiments.

Therefore, based on observation and interview the allegation that the facility does not have an adequate food supply is unsubstantiated. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted, and a copy of this report was provided.

SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 18-AS-20250807113043
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: CONCEPT FOR LIFE HOME LLC
FACILITY NUMBER: 331881201
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/26/2025
Section Cited
CCR
80072(a)(1)
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80072 Personal Rights (a)…each client shall have personal rights which include…(1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement was not met as evidenced by:
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The licensee agreed to have all staff including the licensee attend outside resource training on the topics of Personal Rights CCR Title 22 80072(a)(1), submit proof of completion and topics discussed in the training by the POC due date.
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Based on observation, interview, and record review S1 sent inappropriate text messages to C2. This poses a potential health, safety, or personal rights risk to clients in care.
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Type B
08/26/2025
Section Cited
CCR
80072(a)(3)
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80072 Personal Rights (a)…each client shall have personal rights which include…(3) To be free from…unusual punishment…humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature… This requirement was not met as evidenced by:
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The licensee agreed to have all staff including the licensee attend outside resource training on the topics of Personal Rights CCR Title 22 80072(a)(3), submit proof of completion and topics discussed in the training by the POC due date.
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Based on interview, record review, and observation S1 blocked clients expect C1 and dismissed client’s concerns on C1’s visitors. This poses a health, safety or personal rights risk to clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 6