336425204-7-10-2024-18-AS-TDAN-D7QTVG-20240801150354

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336425204
Report Date: 07/10/2024
Date Signed: 07/10/2024 02:02:47 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
07/02/2024 and conducted by Evaluator Janira Arreola

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20240702125949

FACILITY NAME:	TEMPLE PARK LIVING		FACILITY NUMBER:	336425204
ADMINISTRATOR:	ESTA HOBBS		FACILITY TYPE:	740
ADDRESS:	40112 TENNYSON RD.		TELEPHONE:	(951) 239-1557
CITY:	MURRIETA	STATE: CA	ZIP CODE:	92563
CAPACITY:	6	CENSUS: 5	DATE:	07/10/2024
		UNANNOUNCED	TIME BEGAN:	01:42 PM
MET WITH:	Staff, Mauhammad Alvi		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff are dispensing resident pills a week in advance

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Janira Arreola, conducted an unannounced visit to the facility in order to investigate the above allegations. LPA met with Staff, Mauhammad Alvi, who was informed of the purpose of the visit. During the visit, LPA conducted interviews and conducted a walk through.

It was alleged that staff prepare medication (1) week in advanced for the facility residents. LPA conducted a walk through inspection of the resident medications and facility and did not observed medication prepoured for residents. LPA conducted (2) staff interview which revealed that staff do not prepour medications for residents. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janira Arreola	TELEPHONE: 951-233-6759
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024

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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