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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881358
Report Date: 11/08/2025
Date Signed: 11/08/2025 12:27:12 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
10/24/2023 and conducted by Evaluator Jose Gary Tan
COMPLAINT CONTROL NUMBER: 18-AS-20231024121610
FACILITY NAME:SUN CITY GARDENSFACILITY NUMBER:
331881358
ADMINISTRATOR:ROBYN REBOLLARFACILITY TYPE:
740
ADDRESS:28500 BRADLEY ROADTELEPHONE:
(951) 679-2391
CITY:SUN CITYSTATE: CAZIP CODE:
92586
CAPACITY:74CENSUS: 52DATE:
11/08/2025
UNANNOUNCEDTIME BEGAN:
06:13 AM
MET WITH:Amber Suttie - Resident Service DirecotrTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff locked residents in their rooms.
Facility is in disrepair
INVESTIGATION FINDINGS:
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The reason for the subsequent visit it to make a correction on the citation and provide additional information not included on the report dated 5/17/25, all other findings remain the same.

Licensing Program Analyst (LPA) Jose Tan conducted an unannounced subsequent visit at this facility to further investigate the above allegation. LPA met with Brenda Sanchez and explained the reason for the visit.

LPA conducted physical plant tour at 11:00 AM, requested copies of facility documents relevant to the investigation at 11:20 AM and interviewed staff and resident between 11:30:00 AM to 2:00 PM. Regarding the allegation that Staff locked residents in their rooms, it was alleged that residents' Memory Care doors were locked from the outside. LPA's physical plant tour today revealed that residents' door at Memory care were locked from the outside even when the resident is inside the room.

(continued on LIC 9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2025
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-20231024121610
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: SUN CITY GARDENS
FACILITY NUMBER: 331881358
VISIT DATE: 11/08/2025
NARRATIVE
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(continued from LIC 9099)

Regarding the allegation that Facility is in disrepair, it was alleged that Door at Memory Care in Bldg. 200 was broken and wide open 24/7. LPA Goodrich's physical plant tour on 10/31/23 revealed that the door was broken and had been broken for a while during LPA's visit. LPA Goodrich's interview with three (3) other staff also confirmed that the door was broken but they are trying to fix it.

Based on the information gathered during this and prior visit, these allegation are deemed substantiated at this time.

Citation issued. Appeal rights explained and given. Exit interview conducted. Copy of this report issued.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20231024121610
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: SUN CITY GARDENS
FACILITY NUMBER: 331881358
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/19/2025
Section Cited
CCR
87468.1(a)(6)
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(6) To leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night. This does not prohibit a licensee from establishing house rules, such as locking doors at night to protect residents, or barring windows against intruders, with permission from the Department.
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RSD will inform the management to remove the lock of the door at the memory care unit and will submit statement of understanding of the above cited regulation and submit proof of removal and statement to CCL on/or before the POC date.
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This requirement is not met as evidenced by:

Based on LPAs observation, memory care residents' door were locked even if the resident is inside. This poses an immediately health and safety and personal rights risk to the residents in care
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Type A
05/17/2025
Section Cited
CCR
87303(a)
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The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.

This requirement is not met as evidenced by:
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LPA observed during visit the door is repaired and in good condition. Cleared during visit.
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Based on LPA observation the licensee did not ensure that the door of Memory care was in good repair. This poses a potential health and safety risk to the residents 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: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3