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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881323
Report Date: 08/04/2025
Date Signed: 08/04/2025 11:09:33 AM

Unfounded


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
07/29/2025 and conducted by Evaluator Debbie Palacios
COMPLAINT CONTROL NUMBER: 18-AS-20250729095703
FACILITY NAME:GROVE ASSISTED LIVING, THEFACILITY NUMBER:
331881323
ADMINISTRATOR:MORA, MICHELLEFACILITY TYPE:
740
ADDRESS:3401 LEMON STREETTELEPHONE:
(951) 686-8202
CITY:RIVERSIDESTATE: CAZIP CODE:
92501
CAPACITY:66CENSUS: 63DATE:
08/04/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Angelica Talavera, Office ManagerTIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
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5
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7
8
9
Staff are not safeguarding residents personal belongings.
Staff are financially abusing residents.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Debbie Palacios conducted an unannounced visit to the facility to initiate the investigation into the allegations listed above. LPA met with Office Manager Angelica Talavera and was informed of the purpose of the visit.

During the visit, LPA toured the facility and conducted two (2) staff interviews. LPA requested resident records, resident roster, and staff roster for review. Information obtained from records reviewed revealed Resident # 1 (R1) is not a resident at the facility. LPA conducted an interview with office manager Angelica Talavera who reported R1 has never resided at the facility, R1 was admitted to the Skilled Nursing Facility on 01/23/23 and was discharged on 03/29/24. LPA conducted an interview with staff #1 (S1) and reported that R1 has never resided at the Assisted Living facility.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Debbie Palacios
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2025
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-20250729095703
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: GROVE ASSISTED LIVING, THE
FACILITY NUMBER: 331881323
VISIT DATE: 08/04/2025
NARRATIVE
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This agency has investigated the complaints alleging staff are not safeguarding residents personal belongings and staff are financially abusing residents. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted, and a copy of this report was provided.
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Debbie Palacios
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2