331800055-8-28-2025-18-AS-RSTS-DKZUNC-20250829154342

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331800055
Report Date: 08/28/2025
Date Signed: 08/28/2025 01:35:57 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
05/08/2025 and conducted by Evaluator Debbie Palacios

COMPLAINT CONTROL NUMBER: 18-AS-20250508082843

FACILITY NAME:	COTTAGES AT HEMET		FACILITY NUMBER:	331800055
ADMINISTRATOR:	BOTTINELLI,SHEILA		FACILITY TYPE:	740
ADDRESS:	1177 S PALM AVE		TELEPHONE:	(951) 923-2844
CITY:	HEMET	STATE: CA	ZIP CODE:	92543
CAPACITY:	110	CENSUS: 77	DATE:	08/28/2025
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Barbara Bogoje, Executive Director		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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The Licensee is requiring the resident to execute another admissions agreement.
Licensee is overcharging resident fees.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Debbie Palacios conducted an unannounced visit to deliver findings for the allegation listed above. LPA met with Executive Director Barbara Bogoje where LPA explained the purpose of the visit and the elements of allegation. The investigation consisted of interviews with staff members and residents, and a review of records.

It was alleged the licensee was requiring the resident to execute another Admissions Agreement when there was already an admissions agreement in place and there had been no change of condition of the resident. Per an interview conducted with the Executive Director (ED), it was reported that a new admission agreement was introduced solely to reflect the facility’s name change from Pacifica Senior Living to Cottages at Hemet. Through record review and interviews LPA verified there was no new admissions agreement signed. LPA attempted to contact both R1 and their responsible party but was unsuccessful.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Debbie Palacios
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025

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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Control Number 18-AS-20250508082843

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: COTTAGES AT HEMET	FACILITY NUMBER: 331800055
	VISIT DATE: 08/28/2025

NARRATIVE

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Regarding the allegation the licensee is overcharging resident fees, it was alleged the facility was requiring the resident to pay a second one-time Community Fee that had previously been paid in August of 2023. The ED reported a request for residents to sign a new admission agreement was introduced solely to reflect the facility’s name change. Although the new admission agreement reflected the language of the one-time Community Fee, staff were not requiring residents to pay the community fee, as it had already been paid. LPA attempted to contact both R1 and their responsible party but was unsuccessful.

Additional residents were selected at random and interviewed. Three of six residents interviewed reported that their families handle the financial aspects including monthly payments and administrative matters. Additionally, the remaining three of six residents reported that facility staff have never pressured or forced them to sign any documents.

Although the allegations may have happened or are valid, there is no preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

An exit interview was conducted, and a copy of this report was provided.

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Debbie Palacios
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025

LIC9099 (FAS) - (06/04)

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