<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881323
Report Date: 04/28/2026
Date Signed: 04/28/2026 02:44:32 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
11/29/2023 and conducted by Evaluator Deborah Lee
COMPLAINT CONTROL NUMBER: 18-AS-20231129150528
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: 62DATE:
04/28/2026
UNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Alberto GonzalezTIME COMPLETED:
02:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not ensure that resident is adequately fed while in care.
Staff does not meet resident's grooming needs.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On April 28, 2026, the Department of Social Services staff conducted an unannounced visit to this facility to continue investigation of the above allegation and to deliver findings. The Department was met by Alberto Gonzalez and reason for visit explained

Investigation consisted of the following:
On December 6, 2023, the Department conducted an unannounced initial visit to the facility to investigate the complaint allegation mentioned above. During the visit, it was determined that the complaint required further investigation.
On April 28, 2026, the Department obtained copies of the following documents: Staff oster dated 4/15/26), Resident Roster (dated: 4/22/26), R1’s medical reports (dated: 9/8/23) R1’s pre-appraisal (dated: 9/9/23) R1’s Needed and services plan (dated: 9/9/23), Dietary Request form (dated: 9/8/23), Shower Scheduled, Medication Orders 9/8/23 Physician orders (9/8/23), and Menu (March 2026) The department interviewed Administrator (A1) 4 staff (S1-S4), 6 Residents (R2-R7). R1 no longer lives at the facility as of 3/1/23).
Page 1 of 4

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2026
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-20231129150528
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: 04/28/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The investigation revealed the following:

Allegation: Staff does not ensure that resident is adequately fed while in care.

The detail of the complaint alleges R1 is only given a small portion of food and doesn't appear to be eating well.

On April 28, 2026, the department interviewed Wellness Coordinator (A1) who denied the allegation stating that there has been no report of R1 not getting enough food here. A1 further stated that R1 was a “good eater” that he was given snacks or extra food when he requested it. Lastly, A1 stated that residents could ask for "seconds" of meals if they wanted and his staff would provide it.

On April 28,2026 between 12:30pm and 1:30pm the department interviewed 4 staff (S1-S4) regarding the allegation and 4 out of 4 denied the allegation stating that residents are adequately fed at the facility. 4 out of 4 stated that if residents ask for extra food or snacks they are available to them. Lastly, when asked what happens if a resident refuses food, 4 out 4 staff interviewed stated that they have an alternative meal option for the residents. Lastly, 1 of the 4 staff interviewed informed the department that she follows a recommended portion spread sheet that is from a Registered Dietician however, it can be adjusted based on the preference and need of the resident.

On April 28, 2026 the department interviewed 6 residents (R2-R7) regarding the allegation 6 out of 6 denied the allegation stating that get enough to eat and if they wanted “seconds” they are given "seconds." When asked if they have access to snacks, 6 out of 6 stated that they are offered snacks. Lastly, 6 out of 6 residents interviewed stated that they are well taken care of and the staff assist them when needed.

Page 2 of 4

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 18-AS-20231129150528
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: 04/28/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
On April 28, 2026, the department obtained, reviewed and evaluated the following documents: Resident Roster (dated: 4/22/26), R1’s medical reports (dated: 9/8/23) R1’s pre-appraisal (dated: 9/9/23) R1’s Needed and services plan (dated: 9/9/23), Dietary Request form (dated: 9/8/23), Medication Orders 9/8/23 Physician orders (9/8/23), and Menu (March 2026)

On April 28, 2026 during tour of the facility, department observed meal service and noted the portion sizes were adequate and well balanced.

Based on the information gathered, there is insufficient 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.

Allegation: Staff does not meet resident's grooming needs.

The detail of the allegation alleges that on 11/25/23 R1 was observed as not well groomed

On April 28, 2026, the Department interviewed Wellness Coordinator (A1) who denied the allegation and stated that there were no reports of R1 not being well groomed. A1 further stated that he observed R1 daily and there were no issues in that area. A1 stated that he would have addressed it that was an issue.

Page 3 of 4

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 18-AS-20231129150528
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: 04/28/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
On April 28, 2026, the department interviewed 4 staff regarding the allegation. Of those interviewed 4 out of 4 denied the allegation citing that they follow a shower schedule for the residents and that all residents are properly groomed.

On April 28, 2026 the department interviewed 6 residents and of those interviewed 6 out of 6 state they are well care for and their grooming and hygiene needs are met.

On April 28, 2026, the department observed that the residents were adequately dressed and properly groomed.

On April 28, 2026, the department obtained and reviewed a copy of the facility shower schedule and found it to be consistent.

Based on the information gathered, there is insufficient 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.

Page 4 of 4

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4