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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881250
Report Date: 07/22/2025
Date Signed: 07/22/2025 09:42:45 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
02/07/2025 and conducted by Evaluator Abdoulaye Zerbo
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20250207101715
FACILITY NAME:HOME OF COMFORT LLCFACILITY NUMBER:
331881250
ADMINISTRATOR:VANESSA TAYLORFACILITY TYPE:
735
ADDRESS:26545 ROLAND ROADTELEPHONE:
(951) 987-6069
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY:4CENSUS: 4DATE:
07/22/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Kayti MasonTIME COMPLETED:
09:45 AM
ALLEGATION(S):
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Staff did not prevent client from leaving the facility unassisted
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an unannounced visit to the facility to deliver findings related to a complaint alleging that staff failed to prevent a resident from leaving the premises unassisted. Upon arrival, LPA was welcomed by Licensee Tasha Hawkins, and a health and safety check was promptly conducted. No immediate concerns or violations were observed during the tour. Interviews with staff and review of relevant documentation were conducted to assess the validity of the allegation.

During the investigation, LPA reviewed Resident 1’s (R1) records, which included an Individual Program Plan (IPP) documenting a known history of elopement behaviors. Staff interviews confirmed that R1 occasionally attempts to leave the facility, and preventive measures are in place to ensure the resident’s safety during such incidents. These include staff closely monitoring R1’s movements and staying within close proximity to guide and assist as needed.
Continued 9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Abdoulaye Zerbo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2025
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 2
Control Number 18-AS-20250207101715
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: HOME OF COMFORT LLC
FACILITY NUMBER: 331881250
VISIT DATE: 07/22/2025
NARRATIVE
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Based on the evidence, the allegation mentioned above is UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means 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 at this time.

An exit interview was conducted where this report, LIC9099 was discussed and provided to Licensee Tasha Hawkins.

This is an amended version of the original report created on 04-17-25. The findings were clarified and a new 9099 now supersedes it.

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Abdoulaye Zerbo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2