<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336427427
Report Date: 06/29/2026
Date Signed: 06/29/2026 12:03:23 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
06/25/2026 and conducted by Evaluator Ivashia Wright
COMPLAINT CONTROL NUMBER: 18-AS-20260625162431
FACILITY NAME:NEW HOPE RESIDENTIAL ELDER CARE II LLCFACILITY NUMBER:
336427427
ADMINISTRATOR:MIKENAS, ANNIE JANEFACILITY TYPE:
740
ADDRESS:30221 POWDERHORN LANETELEPHONE:
(951) 467-0330
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY:6CENSUS: 6DATE:
06/29/2026
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Annie Jane Mikenas, AdministratorTIME COMPLETED:
12:10 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not ensure there was adequate food for residents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On June 29, 2026, Licensing Program Analyst (LPA), Ivashia Wright, arrived unannounced at the facility to initiate a complaint investigation. LPA met with the Caregiver, Viva Gregorio. The LPA introduced themselve and explained the purpose for the visit. Administrator Annie Jane Mikenas arrived shortly after. LPA interviewed staff, Administrator and requested documentation. LPA also inspected the existing food supply.

Regarding the allegation that Staff did not ensure there was adequate food for residents. LPA did not observe sufficient food to meet the 2 day perishable, 7 day non-perishable mandated by regulations. Interview with Administrator Annie informed LPA that she was out of the country. Annie stated staff were to call her son for grocery needs every Friday. Annie stated there is no menu provided to residents due to residents having different food options and needs.

Continued on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Ivashia Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026
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-20260625162431
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: NEW HOPE RESIDENTIAL ELDER CARE II LLC
FACILITY NUMBER: 336427427
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/29/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/30/2026
Section Cited
HSC
87555(b)(26)
1
2
3
4
5
6
7
87555 General Food Service Requirements (b) The following food service requirements shall apply: (26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. This requirement is not as evidenced by:
1
2
3
4
5
6
7
Administrator to certify that the facility will maintain nonperishable foods for a minimum of one week and perishable foods for a minimum of two days. Proof of correction must be submitted to LPA Wright by 5pm on 6/29/2026.
8
9
10
11
12
13
14
Based on observation, Licensee did not ensure the food supply for the number of residents, the facility has failed to meet the required supplies of maintaining on the premises nonperishable foods for a minimum of one week and perishable foods for a minimum of two days.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Jazmond D Harris
LICENSING EVALUATOR NAME: Ivashia Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 18-AS-20260625162431
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: NEW HOPE RESIDENTIAL ELDER CARE II LLC
FACILITY NUMBER: 336427427
VISIT DATE: 06/29/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
 Information obtained from interviews with staff stated grocery shopping days were Saturday or Sundays. Interview with additional Staff stated they notified the son of grocery needs but too many things were needed and son couldn't supply all grocery needs. Staff did corroborated that the Administrator was out of country and that the son of the Administrator was responsible for providing grocers for the facility.

Based on staff interviews, facility records, and LPA observations the allegation that staff did not ensure there was adequate food for residents is deemed substantiated. A substantiated finding means that the preponderance of evidence standard has been met; therefore, the above allegation is found to be Substantiated.

A copy of this report, LIC 9099D, and appeal rights are being provided to Administrator Annie.

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Ivashia Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3