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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336425056
Report Date: 06/27/2025
Date Signed: 06/27/2025 02:51:40 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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
04/23/2025 and conducted by Evaluator Mary Rico
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20250423162100
FACILITY NAME:MANITOBA RESIDENTIAL CAREFACILITY NUMBER:
336425056
ADMINISTRATOR:CHARISSE MCCOYFACILITY TYPE:
735
ADDRESS:1703 MANITOBA CIRCLETELEPHONE:
(951) 531-8952
CITY:CORONASTATE: CAZIP CODE:
92882
CAPACITY:5CENSUS: 4DATE:
06/27/2025
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Staff- Rashad Bowie TIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Due to lack of staff, residents are eloping.
Staff are leaving residents unsupervised.
Staff do not ensure appliances are working properly.
Staff are taking away residents personal property as punishment.
Staff are limiting tabacoo use for residents.
Staff are not criminally record cleared.
Staff do not ensure meals are of quantity to meet the needs of the residents.
Staff do not allow residents to have visitors.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPA) Mary Rico conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with staff Rashad Bowie and explained the purpose of the visit. The Administrator Charisse Mccoy was also contacted and informed about today’s visit. The investigation consisted of staff interviews, client interviews and record review.

For the allegation, Due to lack of staff, residents are eloping. During staff interviews 3 out of the 3 staff stated the facility has enough staff memebers available per shift to meet residents needs and to assist if they AWOL. Based on record review, LPA observed facility had sufficient staff available to meet resident needs.

For the allegation, Staff are leaving residents unsupervised. During staff interviews 3 out of the 3 staff stated they have not left their residents unsupervised at facility. During resident interviews 3 out of the 3, residents stated they have not been left alone.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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
04/23/2025 and conducted by Evaluator Mary Rico
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20250423162100

FACILITY NAME:MANITOBA RESIDENTIAL CAREFACILITY NUMBER:
336425056
ADMINISTRATOR:CHARISSE MCCOYFACILITY TYPE:
735
ADDRESS:1703 MANITOBA CIRCLETELEPHONE:
(951) 531-8952
CITY:CORONASTATE: CAZIP CODE:
92882
CAPACITY:5CENSUS: 4DATE:
06/27/2025
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Staff- Rashad BowieTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not have required training.
Staff do not treat resident with respect.
Staff do not allow resident to choose own clothing to wear.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPA) Mary Rico conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with staff Rashad Bowie and explained the purpose of the visit. The Administrator Charisse Mccoy was also contacted and informed about today’s visit. The investigation consisted of staff interviews, client interviews and record review.

For the allegation, Staff do not have required training. During staff interviews, 3 out of the 3 staff stated they have completed their training and are also provided yearly training. During record review, LPA Rico review all staff memebers have completed their required training.

For the allegation, Staff do not treat resident with respect. During staff interviews 3 out of the 3 staff stated they are treated their resident with respect. During resident interviews, 3 out of the 3 residents stated staff do not disrespect them.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 56-AS-20250423162100
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: MANITOBA RESIDENTIAL CARE
FACILITY NUMBER: 336425056
VISIT DATE: 06/27/2025
NARRATIVE
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32
For the allegation, Staff do not allow resident to choose own clothing to wear. During staff interviews 3 out of the 3 staff stated their residents choose with own clothes and encourage independence. During resident interviews 3 out of 3 the resident stated they are allowed to choose their own clothes.

Based on the evidence found during the investigation, the (3) allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.


An exit interview was conducted, and this report (LIC9099) was discussed and provided to staff Rashad Bowie and a copy was also emailed to Administrator Charisse McCoy.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 56-AS-20250423162100
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: MANITOBA RESIDENTIAL CARE
FACILITY NUMBER: 336425056
VISIT DATE: 06/27/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
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24
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26
27
28
29
30
31
32
For the allegation, Staff do not ensure appliances are working properly. During staff interviews, 3 out of the 3 staff stated appliances are working properly. During facility tour, LPA observed appliances to be working properly.

For the allegations, Staff are taking away residents’ personal property as punishment. During staff interviews, 3 out of the 3 staff stated they do not punish their residents and do not remove their personal items. During resident interviews 3 out of the 3 residents stated they have not been punished, and no personal item has been removed.

For the allegation, Staff are limiting tobacco use for residents. During staff interviews 3 out of the 3 staff stated they allow residents to smoke outside and do not limit their restrictions. During residents’ interviews 3 out of the 3 residents stated they do not like to smoke.

For the allegation, Staff are not criminally record cleared. During staff interviews, 3 out of the 3 staff stated they have a criminal record clearance. Based on record review LPA Rico verify all staff members associated to the facility have a criminal record clearance.

For the allegation, Staff do not ensure meals are of quantity to meet the needs of the residents. During staff interviews, 3 out of the 3 staff stated the facility has enough quantity of food available for residents. During residents’ interviews, 3 out of the residents stated the staff will provide more food when needed. During facility tour, LPA Rico observed the facility had enough food available for residents.

For the allegation, Staff do not allow residents to have visitors. During staff interviews, 3 out of the 3 staff stated residents are allowed to have visitors. During resident interviews, 3 out of the 3 residents stated they are allowed to have visits.

Based on the evidence found during the investigation, the eight (8) allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.


An exit interview was conducted, and this report (LIC9099) was discussed and provided to staff Rashad Bowie and a copy was also emailed to Administrator Charisse McCoy.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4