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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881582
Report Date: 09/16/2026
Date Signed: 09/16/2026 10:43:28 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
09/11/2026 and conducted by Evaluator Valerie Flores
COMPLAINT CONTROL NUMBER: 18-AS-20260911082207
FACILITY NAME:MURRIETA GARDENSFACILITY NUMBER:
331881582
ADMINISTRATOR:KAVENAUGH, BRITTANYFACILITY TYPE:
740
ADDRESS:24200 MONROE AVETELEPHONE:
(951) 600-7676
CITY:MURRIETASTATE: CAZIP CODE:
92562
CAPACITY:126CENSUS: 53DATE:
09/16/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator Brittany KavenaughTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff did not provide adequate supervision, resulting in a resident ingesting a balloon
INVESTIGATION FINDINGS:
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On 9/16/2026, Licensing Program Analyst (LPA) Valerie Flores conducted an unannounced visit to the facility for the purpose of launching the complaint investigation into the allegation listed above. LPA Flores met with Administrator Brittany Kavenaugh and explained the purpose of the visit. The investigation is summarized as follows:

On 9/11/2026, Community Care Licensing (CCL) received information alleging staff did not provide adequate supervision, resulting in Resident #1 (R1) ingesting a balloon. Staff interviews report that they are unsure how R1 ingested a balloon when the facility does not use balloons for decorations. Staff further reported that the facility use to play a balloon toss game with the residents but made the decision to discontinue playing that game in July of 2026 as resident would become frightened when the balloon popped.

(Continue to LIC9099...)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2026
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 2
Control Number 18-AS-20260911082207
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: MURRIETA GARDENS
FACILITY NUMBER: 331881582
VISIT DATE: 09/16/2026
NARRATIVE
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(Continuation from LIC9099)

An interview with Staff #1 (S1) reports that R1 was in the hospital on 9/7/2026 and is unsure if R1 had access to any balloons during R1's hospital stay. LPA Flores attempted to interview R1 but due to R1's cognitive abilities, the interview was unsuccessful. A review of R1's care plan and physician report does not report R1 requiring one-on-one care and supervision.

Therefore, the allegation of "staff did not provide adequate supervision, resulting in a resident ingesting a balloon" is deemed unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means the preponderance of the evidence has not been met.

An exit interview was conducted, and a copy of the report was provided to the Administrator.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2