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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 335530052
Report Date: 01/27/2025
Date Signed: 01/27/2025 03:36:22 PM

Unsubstantiated


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
01/23/2025 and conducted by Evaluator Bernadette Allen
COMPLAINT CONTROL NUMBER: 56-AS-20250123155748
FACILITY NAME:MESA POINTE HOMEFACILITY NUMBER:
335530052
ADMINISTRATOR:CARMEN D. WYDERMYREFACILITY TYPE:
735
ADDRESS:171 TRADITION COURTTELEPHONE:
(951) 452-4565
CITY:CALIMESASTATE: CAZIP CODE:
92320
CAPACITY:4CENSUS: 4DATE:
01/27/2025
UNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Gloria Thomas Licensee TIME COMPLETED:
01:33 PM
ALLEGATION(S):
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Staff does not provide adequate food portions to residents.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bernadette Allen made an unannounced visit to the facility to commence a complaint investigation and deliver findings. LPA identified herself and discussed the purpose of the visit with Gloria Thomas Licensee.

During the investigation, both clients and staff were interviewed. Clients reported that they received adequate food during mealtimes and confirmed that additional portions were available upon request. They also noted that alternative food options could be provided if desired. Staff members stated that clients receive a sufficient amount of food and that shopping, previously done weekly, was changed to twice a week effective January 27, 2025. It appeared that there was a sufficient amount of food in the home for the clients during the visit.

LPA also observed a 7-day supply of non-perishable and a 5-day supply of perishable food items along with weekly grocery invoices.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025
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 56-AS-20250123155748
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME: MESA POINTE HOME
FACILITY NUMBER: 335530052
VISIT DATE: 01/27/2025
NARRATIVE
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Based on the investigation interviews, documentation, and observations the above findings are Unsubstantiated. A finding of unsubstantiated means although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted, and a copy was provided to Gloria Thomas at the conclusion of the visit with the appeal rights.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2