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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881324
Report Date: 10/06/2025
Date Signed: 10/06/2025 11:32:33 AM

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
10/01/2025 and conducted by Evaluator Seo Jeon
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20251001142835
FACILITY NAME:EXECUTIVE RESIDENTIAL CARE & RECOVERY LLCFACILITY NUMBER:
331881324
ADMINISTRATOR:SONYA JESUSFACILITY TYPE:
772
ADDRESS:70806 HALPER LAKETELEPHONE:
(562) 755-9734
CITY:RANCHO MIRAGESTATE: CAZIP CODE:
92270
CAPACITY:6CENSUS: 3DATE:
10/06/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Sonya Jesus, Program DirectorTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Facility is not following required staff to client ratio
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced visit to the facility to initiate the investigation into the allegation listed above. The LPA met with Sonya Jesus, Program Director, and informed them of the purpose of the LPA’s visit. The LPA conducted a tour of the interior and exterior areas of the facility, conducted review of records, obtained, and requested copies of pertinent documentation. LPA interviewed clients and staff.

On October 1, 2025, Community Care Licensing (The Department) received a complaint report with the following allegation.

It was alleged facility is not following required staff to client ratio. LPA obtained and reviewed client/staff rosters and September 2025 staff schedules. LPA observed two (2) to three (3) staff members assigned in every shift on the staff schedule. Continued on LIC9099-C....

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Seo Jeon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2025
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-20251001142835
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: EXECUTIVE RESIDENTIAL CARE & RECOVERY LLC
FACILITY NUMBER: 331881324
VISIT DATE: 10/06/2025
NARRATIVE
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LPA observed three (3) clients present in September 2025 and current. LPA interviewed three (3) clients, all of whom confirmed there has been minimum of two (2) direct care staff members present to provide care for the clients. LPA interviewed three (3) staff members, all of whom also confirmed there has been two (2) to three (3) direct care staff members in each shift. LPA observed three (3) clients, and two (2) direct care staff present which met the required staff to client ratio at the time of LPA’s inspection.

Based on records review and interviews conducted, the allegation that facility is not following required staff to client ratio is unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted, and a copy of this report was provided.

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Seo Jeon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2