335530032-2-22-2023-56-AS-KCLS-CPCUDJ-20230224142938

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 335530032
Report Date: 02/22/2023
Date Signed: 02/22/2023 10:36:54 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/17/2023 and conducted by Evaluator Javier Prieto

COMPLAINT CONTROL NUMBER: 56-AS-20230217171352

FACILITY NAME:	VILLA DE ANZA		FACILITY NUMBER:	335530032
ADMINISTRATOR:	KATHERINE A. TREVINO		FACILITY TYPE:	740
ADDRESS:	5881 EL PALOMINO DRIVE		TELEPHONE:	(951) 683-3333
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92509
CAPACITY:	197	CENSUS: 91	DATE:	02/22/2023
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Katherine Trevino, Executive Director		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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Resident is being illegally evicted.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to investigate an allegation that the resident is being illegally evicted. LPA met with Director Katherine Trevino who provided LPA with notice of eviction and documentation revealing the resident #1 (R1) was substantially in the rears with facility rent and fees. Notice was served to R1 directly and witnesses by third party as well as certified mail. R1 interviewed stated that R1 no longer wished to reside at the facility, aware that R1 was in the rears and obtained outside assistance for relocation.

This agency has investigated the complaint alleging the resident is being illegally evicted violation.We have found that the complaint was UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Javier Prieto	TELEPHONE: 951-217-3135
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023

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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