331881373-3-23-2026-18-AS-RORN-DSRMZN-20260402100322

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331881373
Report Date: 03/23/2026
Date Signed: 03/23/2026 01:29:09 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
12/15/2023 and conducted by Evaluator Kimberly Ramirez

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20231215142712

FACILITY NAME:	COTTON VILLA RCFE		FACILITY NUMBER:	331881373
ADMINISTRATOR:	MESROPYAN, ANAHIT		FACILITY TYPE:	740
ADDRESS:	64982 COTTON CT		TELEPHONE:	(818) 807-1338
CITY:	DESERT HOT SPRINGS	STATE: CA	ZIP CODE:	92240
CAPACITY:	6	CENSUS: 4	DATE:	03/23/2026
		UNANNOUNCED	TIME BEGAN:	11:01 AM
MET WITH:	Administrator Anahit Mesropyan		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff neglected the resident in care
Staff got angry with resident in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced subsequent complaint investigation visit on 03/23/2026 regarding the above allegations. On 12/20/2023, LPA Mixon conducted an unannounced initial complaint investigation, and a need further investigation was documented. During today’s visit LPA Ramirez was greeted by Administrator Mesropyan and explained the purpose of the visit.

The investigation consisted of the following: LPA Ramirez requested and obtained copies of Resident/Client Roster, Staff Roster (LIC 500), Staff#1 - 4 interviews (S1 – S4), Resident#2-3,5 interviews (R2-R3, R5), attempted interview of R4, copies of R1’s hospice care plan, resident appraisal (LIC 603A), preplacement appraisal information (LIC 603), identification and emergency information (LIC 601), physician’s report (LIC 602A), appraisal/needs and services plan (LIC 625), death report (LIC 624A), copy of staff#5 (S5) personnel record, and physical plant tour.

SEE 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Kimberly Ramirez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 18-AS-20231215142712

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: COTTON VILLA RCFE	FACILITY NUMBER: 331881373
	VISIT DATE: 03/23/2026

NARRATIVE

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The investigation revealed the following: regarding the allegation “Staff neglected the resident in care.” It is alleged staff neglected R1. Three (3) out of the three (3) residents interviewed by LPA Ramirez denied this allegation. Resident interviews revealed residents in care do not feel neglected by staff. Four (4) out of the four (4) staff interviewed denied this allegation. R1 is no longer at the facility and was not interviewed during LPA’s visit. During record review, LPA did not observe incident reports which indicated R1 was neglected while in care. During facility tour, LPA Ramirez toured three (3) occupied resident rooms and did not observe any deficiencies. LPA Ramirez observed residents in care to be well groomed and alert. On 12/20/2023, hospice staff interview conducted by LPA Mixon revealed that in December of 2023, facility staff did notify hospice staff about R1’s leaky ileostomy bag and hospice staff arrived to change R1’s bag and leave additional supplies. This interview also revealed that hospice staff trained facility staff on how to change R1’s ileostomy bag and hospice staff observed facility staff properly complete this task. On 12/20/2023, resident interview conducted by LPA Mixon did not corroborate this 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 UNSUBSTANTIATED.

“Staff got angry with resident in care.” It is alleged S5 got angry with R1. Three (3) out of the three (3) residents interviewed by LPA Ramirez denied this allegation. Residents interviewed corroborated they felt “safe” at the facility and felt “respected” by staff. Four (4) out of the four (4) staff interviewed denied this allegation. R1 is no longer at the facility and was not interviewed during LPA’s visit. Interview with Administrator Mesropyan revealed R5 no longer works at the facility and resigned in December of 2024 to move back to their country. LPA attempted to contact R5 via telephone, but all attempts were unsuccessful. On 12/20/2023, resident interview conducted by LPA Mixon did not corroborate this 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 UNSUBSTANTIATED.

No deficiencies were cited. Exit interview was conducted. A copy of this report was provided.

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Kimberly Ramirez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2026

LIC9099 (FAS) - (06/04)

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