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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336426750
Report Date: 12/13/2021
Date Signed: 12/13/2021 10:06:35 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/27/2020 and conducted by Evaluator Amy Goldenberg
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20200727164346
FACILITY NAME:PARTNERS N CARE-CARE HOMEFACILITY NUMBER:
336426750
ADMINISTRATOR:VAUGHAN, BEVERLEEFACILITY TYPE:
740
ADDRESS:5920 COPPERFIELD AVETELEPHONE:
(951) 213-6314
CITY:RIVERSIDESTATE: CAZIP CODE:
92506
CAPACITY:6CENSUS: 4DATE:
12/13/2021
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Karin Vaughn, House ManagerTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Financial abuse
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Amy Goldenberg is conducting this unannounced visit to conclude this agency's investigation into the allegation mentioned above. LPA met with Karin Vaughan, Facility Manager to discuss the findings.

During the course of this investigation interviews were conducted with witnesses, Karin Vaughn, a detective from Riverside Police Department, Adult Protective Services, and R1. LPA collected pertinent reports from outside agencies and bank fraud reports. It is alleged that the facility was fraudulently taking funds from R1. On 4/22/2020 a check posted for $29,618.26 and was returned on 4/23/2020 to Partner N Care LLC. There was a $4580.00 and on 4/22/20 there was a $5400.00 check posted to the facility out of the residents bank. The bank issued a fraud alert based on these transactions. Interviews revealed the following information: R1 resides at Partners N Care Care Home.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amy Goldenberg
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021
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 2
Control Number 18-AS-20200727164346
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: PARTNERS N CARE-CARE HOME
FACILITY NUMBER: 336426750
VISIT DATE: 12/13/2021
NARRATIVE
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 Karin Vaughn reports that she is close friend of R1 and that she took R1 into her home to help in the care for a friend. It is explained by Karin that the funds taken from the account of R1 were for charges of monthly rent. She further explained that prior to their death, R1's spouse wanted to pay up-front several months for their spouses care before they passed. Karin reports that she did not receive those funds as the bank returned the check unfunded. LPA contact with Riverside Police revealed that their case was suspended. Interviews conducted and review of reports and documents collected from other agencies, although raise concern, do not prove within the preponderance of evidence needed to confirm financial abuse. We have found the complaint allegation is unsubstantiated, although the allegation may have happened or is valid: there is not a preponderance of the evidence to prove that the alleged violation occurred. A copy of this report is being reviewed with and furnished to the facility representative.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amy Goldenberg
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2