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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881285
Report Date: 06/25/2025
Date Signed: 06/25/2025 04:27:40 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
06/19/2025 and conducted by Evaluator Abdoulaye Zerbo
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20250619092749
FACILITY NAME:BETTY'S PLACEFACILITY NUMBER:
331881285
ADMINISTRATOR:ARDIE CRENSHAWFACILITY TYPE:
740
ADDRESS:37182 SIERRA GROVE DRIVETELEPHONE:
(951) 316-1549
CITY:MURIETASTATE: CAZIP CODE:
92563
CAPACITY:6CENSUS: 7DATE:
06/25/2025
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Andrew Hardin, AdministratorTIME COMPLETED:
04:40 PM
ALLEGATION(S):
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Licensee is operating beyond the terms and conditions of their license.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Abdoulaye Zerbo and Javina George conducted an unannounced visit to the facility to investigation the allegation listed above. The LPAs met with Caregiver Unique Joshway and informed them of the purpose of the today's visit. LPAs met with Administrator Andrew Hardin at a later time.

It was alleged Licensee is operating beyond the terms and conditions of their license. LPAs conducted a tour, reviewed records, and interviewed residents and staff. Interviews conducted revealed that there is a census of seven (7) residents. Additional Information obtained revealed that R1 was admitted to the facility on March 24, 2025. A records review of the resident roster revealed the roster was updated on 06-24-25. The licensee submitted an increase of capacity which is currently pending. On 03/13/25 the department was notified that the fire clearance had been denied, as there was additional changes that needed to be made. Based on observations, interviews and records review the allegation of Licensee is operating beyond the terms and conditions of their license is substantiated. A finding that the complaint is substantiated means that the allegation is
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Abdoulaye Zerbo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2025
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-20250619092749
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: BETTY'S PLACE
FACILITY NUMBER: 331881285
VISIT DATE: 06/25/2025
NARRATIVE
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valid because the preponderance of the evidence standard has been met. Per Administrator Andrew Hardin R2 is supposed to be leaving the facility today 06/25/25.

Due to a zero tolerance for unapproved capacity increase, the facility is being assessed an immediate civil penalty in the amount of $500, as they are operating over capacity. In addition the Licensee is being invited to the office for a meeting, the date is to be determined.

An exit interview was conducted where a copy of this report 9099C, 9099D, appeal rights, LIC421IM was reviewed and provided to Administrator Andrew Hardin
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Abdoulaye Zerbo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20250619092749
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: BETTY'S PLACE
FACILITY NUMBER: 331881285
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/25/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/26/2025
Section Cited
CCR
87204(a)
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87204 Limitations - Capacity and Ambulatory Status (a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time... This requirement is not met as
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The licensee agrees to relocate R2, on or before end of day 06/26/25. The adress, and phone number of the new facility is to be submitted to the department by 5pm on the due date indicated.
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evidenced by: the licensee accepted R1 after knowing the fire clearance was denied the facility would operate over capacity. This posed an immediated health, safety and personal right risk to persons 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: Rikesha Stamps
LICENSING EVALUATOR NAME: Abdoulaye Zerbo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3