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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336408324
Report Date: 07/12/2026
Date Signed: 07/12/2026 03:51:56 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
10/04/2024 and conducted by Evaluator Antonine Richard
COMPLAINT CONTROL NUMBER: 18-AS-20241004105831
FACILITY NAME:EPSILON RESIDENTIAL HOMEFACILITY NUMBER:
336408324
ADMINISTRATOR:MARY MARTINFACILITY TYPE:
735
ADDRESS:13155 BAGATELLE STREETTELEPHONE:
(951) 656-0366
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY:5CENSUS: 0DATE:
07/12/2026
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:TIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Facility is in financial distress.
INVESTIGATION FINDINGS:
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On July 12, 2026, Licensing Program Analyst (LPA) Antonine Richard began a follow-up investigation into the alleged complaint allegation.

The investigation consisted of the following:
On October 07, 2024, Licensing Program Analysts (LPAs) Debbie Palacios, Armando Perez, and Javina George conducted an unannounced visit to the facility to initiate a complaint investigation into the allegations listed above. LPAs met with Caregiver Kathleen Davis and Administrator Mary Martin, who was available by telephone, and explained the purpose of the visit and the elements of the allegations.
The LPAs conducted a tour of the interior/exterior areas of the facility, reviewed records, and obtained and requested copies of pertinent documentation. Kathleen was advised that, at this time, additional time is needed and that follow-up visits and/or telephone calls are necessary before reaching investigation findings.

Report Continue on LIC9099C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026
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 3
Control Number 18-AS-20241004105831
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: EPSILON RESIDENTIAL HOME
FACILITY NUMBER: 336408324
VISIT DATE: 07/12/2026
NARRATIVE
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Allegation: Facility is in financial distress.

It is alleged that staff were bringing food from home, along with hand soap, laundry soap, paper towels, and Swiffer mop head pads for cleaning. They were also not paid on time, and their pay never matched what they expected. Additionally, the clients were not given their weekly P&I money.

On June 15, 2026, LPA Antonine Richard began a follow-up investigation visit. LPA Richard attempted to call the reporting party and the facility using the provided numbers but did not receive a return call. On the same day, LPA Richard arrived at the facility and rang the doorbell, but no one answered. The property appeared closed and as if no one lived there. On Jul 09, 2026, LPA Richard searched Zillow and found that the property is in foreclosure and will be auctioned on August 07/2026. A sign was posted: “No person is permitted to enter this property. Any person caught entering the property may be guilty of trespassing.”

The resident's whereabouts are unknown at this time. Because the facility is in the process of closing, we were unable to locate all parties involved in the complaint. LPA was unable to review any documents and interviewed clients and staff. As a result, we were unable to complete a full investigation.

Report continue on LIC9099C

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20241004105831
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: EPSILON RESIDENTIAL HOME
FACILITY NUMBER: 336408324
VISIT DATE: 07/12/2026
NARRATIVE
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Based on this investigation, LPA finds that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation(s) did or did not occur; therefore, the allegation is UNSUBSTANTIATED.

No deficiencies were cited.

A copy of this report will be mailed to the last known address:

To: COMMUNITY VALLEY HOMES

P.O. Box 7307, Moreno Valley, CA 92553.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3