336423609-8-11-2026-56-AS-KCLS-DWXSSQ-20260814140818

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336423609
Report Date: 08/11/2026
Date Signed: 08/11/2026 06:03:29 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO 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
04/13/2026 and conducted by Evaluator Raquel Hernandez

COMPLAINT CONTROL NUMBER: 56-AS-20260413163430

FACILITY NAME:	MERCY HOME		FACILITY NUMBER:	336423609
ADMINISTRATOR:	MERCILLINA AJUNWA		FACILITY TYPE:	740
ADDRESS:	32350 HEARTH GLEN CT		TELEPHONE:	(951) 926-0195
CITY:	WINCHESTER	STATE: CA	ZIP CODE:	92596
CAPACITY:	6	CENSUS: 0	DATE:	08/11/2026
		UNANNOUNCED	TIME BEGAN:	05:30 PM
MET WITH:	Administrator Mercillina Ajunwa		TIME COMPLETED:	06:10 PM

ALLEGATION(S):

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Resident was not allowed afforded activities or allowed to go outside backyard.
Resident sustained cuts while in care.
Resident was forced to go to bed.
Facility did not have sufficient care staff for residents to be in multiple areas of the facility.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Raquel Hernandez conducted an unannounced visit for the purpose of delivering findings for the above allegations. LPA met with Administrator Mercillina Ajunwa and explained today's visit.

On 04/13/2026, the licensing department received a complaint in regard to facility not offering activities or allowed to go out into backyard, a resident sustained cuts while in care, a resident was forced to go to bed, and facility does not have sufficient staff to care for residents in needs. During investigation, LPA observed facility does offer multiple activities and observed multiple activties to be offered. The investigation consisted of (2) resident interviews. Licensing Program Analyst (LPA) Andrew Martinez attempted to interview Resident #1 (R1), however, R1 does not reside at the facility anymore. LPA Martinez interviewed Resident #2 (R2) who stated activities are provided to residents and facility staff do not restrict residents to go outside. Furthermore, LPA spoke with Administrator in regards to Resident #1 (R1) sustaining cuts while in care. Administrator stated R1 did sustain cuts while in care, however, it was not from or due to facility staff.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2026

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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Control Number 56-AS-20260413163430

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: MERCY HOME	FACILITY NUMBER: 336423609
	VISIT DATE: 08/11/2026

NARRATIVE

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LPA did not corroborate enough evidence that R1 sustaining cuts were due to facility staff. In addition, there was not enough evidence to corroborate that facility staff force residents to go to bed. Additionally, LPA observed facility does not currently retain any residents. Administrator stated facility does have additional staff to work at facility when facility accepts new residents.

Based on the evidence gathered during today’s investigation, the allegation listed above is deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and this report (LIC9099) was discussed and provided to Administrator Mercillina Ajunwa.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2026

LIC9099 (FAS) - (06/04)

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