331881317-9-16-2025-18-AS-RORN-DLRMR2-20250922094936

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331881317
Report Date: 09/16/2025
Date Signed: 09/16/2025 03:36:35 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
11/16/2022 and conducted by Evaluator Antonine Richard

COMPLAINT CONTROL NUMBER: 18-AS-20221116155145

FACILITY NAME:	MISSION BELL ADULT RESIDENTIAL CARE HOME		FACILITY NUMBER:	331881317
ADMINISTRATOR:	BOYER, MARITES		FACILITY TYPE:	735
ADDRESS:	435 IDYLLWILD DRIVE		TELEPHONE:	(951) 654-0774
CITY:	SAN JACINTO	STATE: CA	ZIP CODE:	92583
CAPACITY:	15	CENSUS: 14	DATE:	09/16/2025
		UNANNOUNCED	TIME BEGAN:	10:03 AM
MET WITH:	BOYER MARITES		TIME COMPLETED:	03:34 PM

ALLEGATION(S):

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Resident was slapped across face and hit top of head by staff.
Resident was yelled at by staff for reporting.

INVESTIGATION FINDINGS:

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On 09/16/2025, Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced complaint visit at this facility. LPA met with the Administrator, Marites Boyer. LPA explained that the purpose of this visit is to complete the investigation and deliver findings for the allegations mentioned above. LPA was granted access to the facility.
Investigation included: interviews with Administrator (A1), client interviews (C1-C5), and staff interviews (S1-S3). A review of the following documents: client roster, personnel roster, service records for (S1-S3), facility staff in-service trainings, and other relevant records related to this complaint, including (C1’s) Physician Report LIC 602A (dated 11/09/23), Needs of Service Plan (dated 2022-2023), Medication Administration Record (MAR), a tour of the facility, the facility's Special Incident Report (dated 11/10/2022), and Inland Regional Center (IRC) conclusion (dated 06/09/23). On 09/16/25, LPA called and attempted to talk to the alleged perpetrator but was unable to and left a voicemail message.

Evaluation Report continues LIC 9099

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025

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-20221116155145

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: MISSION BELL ADULT RESIDENTIAL CARE HOME	FACILITY NUMBER: 331881317
	VISIT DATE: 09/16/2025

NARRATIVE

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Allegation #1: Resident was slapped across the face and hit on the top of the head by staff.

The complaint alleges that the resident was slapped across the face and hit on the top of the head by staff. On 09/16/25, between 10:00 am and 3:00 pm, LPA interviewed the Administrator (A1), who stated that the staff would not hit any clients, noting that doing so would result in termination. On 09/16/25, between 10:00 am and 3:00 pm, LPA interviewed three staff members (S1-S3), and all three confirmed they would not hit or mistreat any clients at the facility. On 09/16/25, between 10:00 am and 3:00 pm, LPA also interviewed five clients (C1-C5). All five denied the allegation, stating that staff members did not hit the clients. (C1-C2) stated that if a staff member slapped or physically hit them, they would lose their job.

On 09/15/2025, LPA records reviewed of staff training included: Caregiver Training (dated: 06/23/23), Direct Care Orientation Training (dated: 06/13/23), Employee Orientation Training (dated: 06/13/23), Time and Attendance (dated: 06/18/24), and Clients' Rights (dated: 06/09/23). (A1) also expressed that the Client's Personal Rights are discussed during Client Meetings. On 09/16/25, LPA reviewed the investigation of the Inland Regional Center (IRC) report (dated 06/09/23) and found no evidence to support the allegation.

Based on the interviews, information received, and records reviewed, there was not sufficient evidence to support the allegation. 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 deemed unsubstantiated.

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 18-AS-20221116155145

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: MISSION BELL ADULT RESIDENTIAL CARE HOME	FACILITY NUMBER: 331881317
	VISIT DATE: 09/16/2025

NARRATIVE

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Allegation #2: Resident was yelled at by staff for reporting.

The complaint alleges that on November 9, 2022, the facility Administrator (A1) yelled at a Client due to being upset. On September 15, 2025, between 10:00 AM and 3:00 PM, the LPA interviewed A1, who denied the allegation. A1 asserted that they would never yell at any clients, as all clients have rights, just like everyone else. A1 also mentioned that clients' rights are protected and promoted through ongoing training and staff meetings. There is mandatory annual in-service training on topics such as Clients' Rights, Behavior Intervention, and Client House Meetings. Additionally, A1 noted that clients' personal rights are discussed in monthly client meetings.

On September 16, 2025, between 10:00 AM and 3:00 PM, the LPA interviewed three staff members (S1, S2, and S3). All three denied the allegation and stated that they did not witness or have any knowledge of such an incident. They also confirmed that they are mandated reporters and would report any instances of unwanted behavior if they occurred.

On September 16, 2025, the LPA reviewed staff training records, which included the following: Caregiver Training on Consumer Rights (dated September 1, 2023), Behavior Intervention Training (dated June 18, 2024), Administrator Training on Mandated Abuse Reporting (dated from January 14, 2023, to September 7, 2024), and Clients House Meetings (dated September 17, 2023, February 14, 2024, and August 23, 2025).

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 18-AS-20221116155145

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: MISSION BELL ADULT RESIDENTIAL CARE HOME	FACILITY NUMBER: 331881317
	VISIT DATE: 09/16/2025

NARRATIVE

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Additionally, on September 16, 2025, the LPA reviewed the investigation report from the Inland Regional Center (IRC) dated June 9, 2023, and found no evidence to support the allegation.

Based on information gathered, an inspection of the facility, observation, and interviews conducted, an analysis of records reviewed, the Department found no 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.

No deficiencies cited.

Exit interview conducted. A copy of this report was provided to the Administrator Marites Boyer

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025

LIC9099 (FAS) - (06/04)

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