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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881258
Report Date: 12/23/2025
Date Signed: 12/23/2025 03:04:50 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
07/08/2024 and conducted by Evaluator Antonine Richard
COMPLAINT CONTROL NUMBER: 18-AS-20240708114623
FACILITY NAME:VINEYARD RANCH AT TEMECULAFACILITY NUMBER:
331881258
ADMINISTRATOR:KELLEY LARAFACILITY TYPE:
740
ADDRESS:27350 NICOLAS ROADTELEPHONE:
(951) 308-1988
CITY:TEMECULASTATE: CAZIP CODE:
92591
CAPACITY:138CENSUS: 89DATE:
12/23/2025
UNANNOUNCEDTIME BEGAN:
09:53 AM
MET WITH:DIZON-GARCIA BITUINTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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Facility staff serve a poor quality of food.
Facility staff do not respond to residents' call button in time manner.
Facility staff force residents to sleep.
INVESTIGATION FINDINGS:
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On December 23, 2025, Licensing Program Analyst (LPA) Antonine Richard made a follow-up visit to gather information and delivered findings regarding the allegations mentioned above. LPA met with the Resident Services Director (RSD),Dizon-Garcia Bituin, and the purpose of the visit was explained. LPA and RSD toured the facility.

The investigation consisted of the following: On December 23, 2025, LPA Richard requested and obtained the following documents: Residents Roster (dated 12/16/2025), Staff Roster (dated 12/06/2025) and facility menu (dated 12/01/2025 to 12/30/2025). LPA also obtained records for Resident #1 (R1), including Face Sheet, Admission Agreement (dated 06/30/2023), Physician Report (dated 08/14/2023), and Needs and Services Plan (dated 07/04/2023 to 01/04/2024), as well as Resident Surrender Property (dated 10/13/2024). The LPA interviewed the Administrator (A1), five staff members (S1-S5), and five Residents (R2-R6).

Report Continued on LIC9099C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
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 4
Control Number 18-AS-20240708114623
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: VINEYARD RANCH AT TEMECULA
FACILITY NUMBER: 331881258
VISIT DATE: 12/23/2025
NARRATIVE
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Allegation #1: Facility staff serve poor-quality food.

The complaint alleged that the facility served lukewarm soup, a sandwich, and undercooked fried food. On December 23, 2025, LPA interviewed the Administrator (A1), who denied the allegation and stated that the facility serves food upon request. The Administrator also mentioned that no residents had complained about receiving cold food. During the same visit, LPA interviewed five staff members #1-5 (S1-S5), all of whom denied the allegation and affirmed that food is served hot. Additionally, S4 explained that the kitchen serves both hot and cold food. If residents order hot food, they receive hot food; if they order cold food, they receive cold food; but otherwise, residents are not served cold or frozen food. On the same day, LPA interviewed five residents #2-6 (R2-R6), all of whom denied receiving cold food when they ordered. They all stated that the soup and French fries are served hot. On December 23, 2025, LPA reviewed the facility menu and the optional menu (dated 11/30 and 12/20/2025), which displayed a variety of food choices for the residents. LPA was unable to interview R1 because R1 moved out of the facility on 10/13/2024.

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.

Report continued on LIC9099C.

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

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 18-AS-20240708114623
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: VINEYARD RANCH AT TEMECULA
FACILITY NUMBER: 331881258
VISIT DATE: 12/23/2025
NARRATIVE
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Allegation #2: Facility staff do not respond to residents’ call buttons in a timely manner.

The complaint alleged that the residents pressed their call buttons for assistance but had to wait 35 minutes for assistance. On December 23, 2025, LPA interviewed the Administrator (A1), who denied the allegation and stated that a staff member could respond to the pendant alarm within 10 minutes. Or the closest staff member to answer the pendant alarm. On December 23, 2025, LPA interviewed five staff members #1-5 (S1-S5), all of whom denied the allegation and stated that as soon as the pendant alarm activates, any available staff member will assist the residents. They also stated that it takes less than ten minutes to respond to the alarm. On December 23, 2025, LPA interviewed five Residents #2-6 (R2-R6), all of whom denied that it took 30 minutes to respond to their alarms after pressing the alarm buttons. They also stated they never had to wait more than 10 minutes. On the same day, LPA observed a resident, R2, pressing the pendant. It takes only 2 minutes for a staff member to respond to the alarm. Furthermore, LPA reviewed the Needs of Service plan (dated 01/04/2024) for R1, which showed that R1 was independent and ambulatory. LPA was unable to interview R1 because R1 moved out of the facility on 10/13/2024.

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.

Report continued on LIC9099C

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

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 18-AS-20240708114623
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: VINEYARD RANCH AT TEMECULA
FACILITY NUMBER: 331881258
VISIT DATE: 12/23/2025
NARRATIVE
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Allegation #3: Facility staff force residents to sleep.

The complaint alleged that a staff member entered the resident's room, yelled at the resident, took the TV remote, and forced the resident to go to sleep. On December 23, 2025, the LPA interviewed the Administrator (A1), who denied the allegation and stated that staff would not force residents to go to bed early. The same day, the LPA also interviewed five staff members, #1-5 (S1-S5), all of whom denied ever asking any residents to go to sleep early. Additionally, on December 23, 2025, the LPA interviewed five residents, #2-6 (R2-R6), all of whom denied ever being asked to go to sleep early. They also stated that the staff are friendly and never force them to go to bed. The LPA was unable to interview R1 because R1 moved out of the facility on 10/13/2024.

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.

No deficiencies were cited.

An exit interview was conducted, and a copy of the report was provided to the Resident Services Director Dizon-Garcia Bituin.

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

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4