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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336427427
Report Date: 07/23/2026
Date Signed: 07/23/2026 12:24:28 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
07/16/2026 and conducted by Evaluator Ivashia Wright
COMPLAINT CONTROL NUMBER: 18-AS-20260716111403
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: 5DATE:
07/23/2026
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH: Jane Annie Mikenas, AdministratorTIME COMPLETED:
12:40 PM
ALLEGATION(S):
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Staff did not ensure there was adequate supply of food available for residents
INVESTIGATION FINDINGS:
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On July 23, 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 themselves and explained the purpose for the visit. Administrator Annie Jane Mikenas arrived shortly after. LPA interviewed staff, Administrator, Witness and requested documentation. LPA also inspected the existing food supply.

Regarding the allegation that Staff did not ensure there was adequate supply of food available for residents, it was reported that there is a concern for the amount of food available and the food may be insufficient to meet nutritional needs for all six residents.

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

DATE: 07/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026
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-20260716111403
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: 07/23/2026
NARRATIVE
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Interview with Annie, the Administrator, stated she has been shopping multiple times for the facility. Annie reported the facility goes shopping on Saturdays, but staff has been requesting more food. Annie stated staff doesn’t want to order too much food because residents hardly eat and do not want food to go bad. Information obtained from interviews with staff stated grocery shopping days were Thursdays and Sundays. Information obtained from interview with R1’s responsible party corroborated that there was a food shortage at the facility. R1’s responsible party stated she believes that there is now a variety of perishable food available. Although the LPA observed that the facility contained the 2-day perishable food requirement, the facility did not have the 7-day non perishable food available to meet the needs of the residents.

Based on witness interviews, staff interviews, facility records, and LPA observations, the allegation staff did not ensure there was adequate supply of food available 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, LIC 421FC, and appeal rights are being provided to Administrator Annie.

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

DATE: 07/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20260716111403
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: 07/23/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/24/2026
Section Cited
CCR
87555(b)(26)
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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:
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Administrator to certify that the facility will maintain nonperishable foods for a minimum of one week. Proof of correction must be submitted to LPA Wright by 5pm on 7/24/2026.
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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.
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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.
SUPERVISOR'S NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Ivashia Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3