336413087-11-3-2025-18-AS-RORN-DNCP9M-20251112100721

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336413087
Report Date: 11/03/2025
Date Signed: 11/03/2025 03:24:09 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
11/28/2023 and conducted by Evaluator Mary G Flores

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20231128085956

FACILITY NAME:	BROOKDALE MURRIETA		FACILITY NUMBER:	336413087
ADMINISTRATOR:	QUEEN AYERS		FACILITY TYPE:	740
ADDRESS:	24350 JACKSON AVE		TELEPHONE:	(951) 696-5753
CITY:	MURRIETA	STATE: CA	ZIP CODE:	92562
CAPACITY:	82	CENSUS: 63	DATE:	11/03/2025
		UNANNOUNCED	TIME BEGAN:	01:38 PM
MET WITH:	Cindy Garcia - Executive Director		TIME COMPLETED:	03:40 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not ensure that resident was bathed
Staff did not provide adequate housekeeping services to resident
Staff did not provide resident transportation to medical appointments

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Mary Flores conducted an unannounced subsequent complaint visit regarding the above allegations. LPA met with Cindy Garcia and explained the reason of the visit.

The investigation consisted of the following: On 12/1/23 LPA Shaw Ross conducted an initial complaint investigation visit, interviewed 4 staff, 1 resident, and requested the pertaining documents. On 10/27/25 LPA Flores contacted administrator and requested copies of physician’s report, service plan, admission agreement, notes, incident reports for resident #1(R1). On 10/29/25 LPA Flores conducted interviews over the phone with 5 staff. On 10/30/25 LPA Flores interviewed 3 residents over the phone. On 11/3/25 LPA Flores conducted a facility tour and observed 6 randomly chosen resident bedrooms, interviewed 3 additional residents and delivered findings for the above allegations.

The investigation revealed the following: Regarding allegation: Staff did not ensure that resident was bathed. It is alleged resident’s baths have been missed and not done as scheduled. (CONTINUED ON LIC 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2025

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 3

Control Number 18-AS-20231128085956

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: BROOKDALE MURRIETA	FACILITY NUMBER: 336413087
	VISIT DATE: 11/03/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Interviews with residents revealed 5 out of 6 residents stated to obtain assistance with showers/bathing as schedule or as needed. 1 out of 6 residents does not need assistance at this time. Interviews with staff revealed residents’ basic services for showers/baths are two showers per week. Unless the resident or responsible party requires more per week, which is discuss and an additional fee is charged. Per staff R1 used to refuse showers/bed baths if a specific staff member was not available or if the staff were late to the scheduled shower. However, the facility staff assisted and encouraged showers. Administrator stated they would ensure the staff was available and that staff showed up at the scheduled time. R1 no longer resides at the facility. Therefore, R1 was not interviewed. Interview with responsible party noted baths were scheduled twice a week. Documents reviewed revealed R1’s admission agreement dated: 8/27/21 notes R1 would receive basic services. Service plan dated 11/1/23 notes R1 was scheduled to receive bed baths twice a week. Although, facility staff may have missed scheduled baths, there are no records that indicate R1 was not assisted with showers for an extended period of time. Therefore, this allegation is unsubstantiated.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Regarding allegation: Staff did not provide adequate housekeeping services to resident. It is alleged resident’s trash bin and bed is not being done daily. Interviews with residents revealed 3 out of 6 residents stated facility staff assist to make their bed daily and take out trash once a week or as needed during their housekeeping day. 2 out of 6 residents stated they make their own bed, but housekeeping cleans their room once a week. 1 out of 6 residents stated there have been times when housekeeping has forgotten to do the resident’s bed and they had to do it on those days. Interviews with staff revealed caregivers are in charge of making the residents’ beds and removing the trash from the residents’ rooms daily. Housekeepers are to clean the apartments once a week, which includes changing the linens. LPA was unable to interview R1, as R1 no longer resides at the facility. On 10/30/25 R1’s responsible party stated that staff was not making the bed at least once per week for an extensive period of time. During facility’s tour conducted on 11/3/25 LPA Flores observed all residents’ beds made and no trash in the residents’ trash cans. Therefore, this allegation is unsubstantiated.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.(CONT. LIC 9099C)

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 18-AS-20231128085956

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: BROOKDALE MURRIETA	FACILITY NUMBER: 336413087
	VISIT DATE: 11/03/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Regarding allegation: Staff did not provide resident transportation to medical appointments. It is alleged facility cannot accommodate transportation to resident’s medical appointments. Interviews with residents revealed 3 out of 6 residents stated to receive assistance with transportation to medical appointments and to not have concerns with facility only scheduling two days out of the week. 3 out of 6 residents either didn’t have a comment about transportation services or did not needed assistance with transportation at this time, therefore, not receive it. Interviews with staff revealed facility’s transportation services for medical appointments are scheduled two days out of the week. If a resident needs assistance on a different day facility staff assist by scheduling other transportation means. Documents reviewed revealed Admission agreement dated: 8/27/21 notes they will provide transportation services to resident #1. Addendum to the Basic Services dated: 8/27/21 guides residents to read the resident handbook for transportation services. LPA reviewed the resident’s handbook and did not find additional information. However, welcome package has listed transportation, "Drop off and Pick up only...Monday & Tuesday Medical appointments."

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview was conducted with Cindy Garcia and a copy of this report was provided.

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 3