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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336425954
Report Date: 03/30/2026
Date Signed: 03/30/2026 02:03:05 PM

Substantiated


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
09/03/2025 and conducted by Evaluator Seo Jeon
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20250903135038
FACILITY NAME:CARMIE CARES HOME FOR THE ELDERLY 1FACILITY NUMBER:
336425954
ADMINISTRATOR:JAY SESEFACILITY TYPE:
740
ADDRESS:32220 SHIFTING SANDS TRAILTELEPHONE:
(760) 656-1177
CITY:CATHEDRAL CITYSTATE: CAZIP CODE:
92234
CAPACITY:0CENSUS: 0DATE:
03/30/2026
UNANNOUNCEDTIME BEGAN:
11:38 AM
MET WITH:Closed FacilityTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Licensee did not issue a timely refund to resident
Licensee did not ensure facility had a working telephone
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Seo Jeon mailed this report to the ex-licensee’s last known mailing address via USPS certified mail, to communicate the findings related to the above-mentioned allegations. The facility has been closed since September 11, 2025
.
On 09-03-2025, the Department received a complaint report with the following allegations.

It was alleged that licensee did not issue a timely refund to resident. According to the information received, Resident #1 (R1) moved out of the facility on 08-04-2025, and R1’s rent was paid until 08-15-2025. LPA conducted an interview with R1’s relevant party (RP), who stated that the licensee owed 10 days of rent paid in advance. RP stated that no refund had been received as of 09-12- 2025. On 10-23-2025, LPA conducted another interview with RP, who stated that the licensee still has not sent the refund.

Continued on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Seo Jeon
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2026
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-20250903135038
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: CARMIE CARES HOME FOR THE ELDERLY 1
FACILITY NUMBER: 336425954
VISIT DATE: 03/30/2026
NARRATIVE
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LPA’s interview with the Administrator on 10-23-2025, confirmed that the refund has not been made. Based on interviews conducted, LPA determined that the Licensee did not issue a refund within 15 days after R1’s move out date. Therefore, the allegation that licensee did not issue a timely refund to resident is substantiated.

It was alleged that licensee did not ensure facility had a working telephone. Information received indicated that the facility phone number was out of service, making the facility unreachable. On 09-11-2025, LPA’s file review revealed there were two (2) telephone numbers associated with the facility. LPA confirmed that those two (2) telephone numbers associated with the facility were out of service. LPA’s further file review revealed that the Licensee did not notify the Department of any change of facility contact information. LPA determined that the facility did not have working telephone, making the facility unreachable. Based on file review and observation, the allegation that licensee did not ensure facility had a working telephone is substantiated.

A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met.

An exit interview was not conducted as the facility has been closed since 09-11-2025. A copy of this report, LIC9099-D, and Appeal Rights were sent to the ex-licensee’s last known mailing address via USPS certified mail, due to the facility closure.

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Seo Jeon
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20250903135038
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: CARMIE CARES HOME FOR THE ELDERLY 1
FACILITY NUMBER: 336425954
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/30/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/30/2026
Section Cited
CCR
87507(f)
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87507 Admission Agreements, (f) The licensee shall comply with all applicable terms and conditions set forth in the admission agreement...

This requirement was not met as evidenced by:
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The ex-Licensee will issue refund and send proof of payment to LPA via email by the POC due date.
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Based on interviews and records review, the Licensee did not issue refund in timely manner. This posed potential personal rights violations to resident in care.
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Type B
03/30/2026
Section Cited
CCR
87311
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87311 Telephones , All facilities shall have telephone service on the premises...

This requirement was not met as evidenced by:
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Licensee closed the facility. There are no residents in care.
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Based on facility visits and verification of the facility phone numbers, the facility did not have working telephone services. This posed potential personal rights and/or health and safety risk to resident in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Seo Jeon
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3