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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880541
Report Date: 02/12/2026
Date Signed: 02/12/2026 11:55:29 AM

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
09/24/2025 and conducted by Evaluator Valerie Flores
COMPLAINT CONTROL NUMBER: 18-AS-20250924084053
FACILITY NAME:ROLLING GREEN SENIOR CAREFACILITY NUMBER:
331880541
ADMINISTRATOR:OKORO, GERTRUDEFACILITY TYPE:
740
ADDRESS:42007 THOROUGHBRED LNTELEPHONE:
(951) 397-3369
CITY:MURRIETASTATE: CAZIP CODE:
92562
CAPACITY:6CENSUS: 4DATE:
02/12/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Administrator Gertrude OkoroTIME COMPLETED:
12:10 PM
ALLEGATION(S):
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Staff do not provided adequate meal service
Staff installed video surveillance in resident's room without proper authorization
Staff do not allow residents to contact emergency services
INVESTIGATION FINDINGS:
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On 2/12/2026, Licensing Program Analyst (LPA) Valerie Flores conducted an unannounced visit to the facility for the purpose of delivering the investigative findings into the allegations listed above. LPA Flores met with Administrator Gertrude Okoro and explained to Gertrude the purpose of the visit. The complaint investigation consisted of observations, interviews, and records review.
Information received alleged staff are not providing adequate meal services to the residents in care. Upon LPA’s initial visit, LPA observed the food to be sufficient in supply that met the requirement of the (2) two-day supply of perishable foods but food lacked in nutritional value to meet the residents nutritional needs. Foods observed in the facility refrigerator consisted of primarily processed foods, and very little fresh produce. LPA reviewed the facility menu, Resident #2 (R2) breakfast ranged from (1) one corn dog, (4) four chicken nuggets, salami and bread, and frozen burritos. Interviews with (4) four out of (4) four residents reported that meals provided to residents are primarily frozen meals or are processed foods.

(Continue to LIC9099C: Substantiated...)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
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 8
Control Number 18-AS-20250924084053
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: ROLLING GREEN SENIOR CARE
FACILITY NUMBER: 331880541
VISIT DATE: 02/12/2026
NARRATIVE
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(Continuation from LIC9099: Substantiated)

Residents report that meals are rarely home cooked are unhappy with the quality of food being provided. LPA Flores conducted an annual visit to the facility in December of 2025. During the annual visit in December of 2025, LPA Flores issued deficiencies for not maintaining food of nutritional value.
Information received alleged staff installed video surveillance in resident’s room without proper authorization. Witness #1 (W1) provided the department with photo proof of the locations of the surveillance cameras. Upon LPA’s initial visit, LPA observed that the camera were removed from the residents bedrooms where it was reportedly installed. LPA Flores and LPA Mixson observed camera mounts and wiring where the camera was once present. LPA interviewed (4) four out of (4) four residents. (3) Three out of (4) four residents reported observing the cameras present but were not given informed consent to have the camera’s in the room. Interview with Resident #1 (R1) stated that they informed Staff #1 (S1) of wanting the camera to be removed from their bedroom but were ignored. A review of the (4) four residents admission agreements detailed that surveillance will be implemented in residents rooms if it was deemed necessary for safety precaution. Interviews with S1 confirmed that video surveillance was implemented for safety concerns. S1 further explained that R1 mental health concerns may place R1 at a health and safety risk which is why the camera’s were implemented in R1’s room. Although R1 may have given written consent during the time of admission, R1 may verbally withdraw the consent at any time. Furthermore, R1 resides in a shared bedroom with R3. Interview with S1 further confirmed that there were no health and safety concerns that would allow the camera’s in the bedrooms for (3) three out of the (4) four residents residing in the facility. The implementation of surveillance camera’s in all resident bedrooms imposed upon the personal rights to privacy to all residents.
Information received alleged staff did not allow Resident #1 (R1) to contact emergency services. Interviews conducted with Staff #1 (S1) believed the allegation stemmed from an incident with R1 explaining that R1 has a history of behavioral episodes resulting to R1 frequently contacting emergency services on numerous occasions. S1 reported that there were occasions when R1 contacted emergency personnel every five minutes. S1 reports that upon law enforcement arrival, law enforcement instructed to take away R1’s personal cell. With the authorization of R1’s child, the cellphone was taken away.

(Continue to LIC9099C: Substantiated)
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 8
Control Number 18-AS-20250924084053
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: ROLLING GREEN SENIOR CARE
FACILITY NUMBER: 331880541
VISIT DATE: 02/12/2026
NARRATIVE
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(Continuation from LIC9099C: Substantiated)

R1 is overseen by a public guardian. S1 stated that they do not recall informing R1’s conservator of removal of R1’s personal cellphone and advised that family members were made aware and were in agreement with S1. Interviews with Resident #1 (R1) confirmed that their personal cellphone was taken away from them without any explanation. R1 reported that they were also denied access to the facility phone to make any personal telephone calls. LPA attempted to speak with R1’s conservator and children to confirm they were informed and authorized S11 to remove the cellphone from R1’s possession, but attempts were unsuccessful.

Therefore, the allegations of staff do not provide adequate meal service, staff installed video surveillance in resident's room without proper authorization, and staff do not allow residents to contact emergency services are deemed substantiated. A finding that the complaint is SUBSTANTIATED means that the allegation is valid as the preponderance of the evidence standard has been met. A citation will be issued in accordance with Title 22 Division 6 Regulations.

An exit interview was conducted, and a copy of this report was provided, along with a copy of LIC9099C (2), LIC9099D, and Appeal Rights were provided.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 8
Control Number 18-AS-20250924084053
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: ROLLING GREEN SENIOR CARE
FACILITY NUMBER: 331880541
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/12/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/26/2026
Section Cited
CCR
87468.2(a)(1)
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(a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (1) To have a reasonable level of personal privacy in accommodations ..., personal care
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The cameras were immediately removed. Administrator agreed to complete an out-service training pertaining to residents personal rights. The training certificate will be submitted to LPA via email by close of business on 2/26/2026.
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and assistance.." This requirement was not met with evidence by: (3) three out of (3) three residents bedroom were equipped with surviellance cameras and residents were not given informed consent permitting the cameras which posed a potential health and safety risk to the resident in care.
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Type B
02/26/2026
Section Cited
CCR
87468.1(a)(14)
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(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (14) To have reasonable access to telephones, to both make and receive confidential calls. This requirement was not met with evidence by: (1) out of (4) four residents were not given access to
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Administrator agreed to complete an out-service training pertaining to residents personal rights. The training certificate will be submitted to LPA via email by close of business on 2/26/2026.
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their personal cellphone which posed a potential health and safety risk to the 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: Anthony Perez
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 8
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
09/24/2025 and conducted by Evaluator Valerie Flores
COMPLAINT CONTROL NUMBER: 18-AS-20250924084053

FACILITY NAME:ROLLING GREEN SENIOR CAREFACILITY NUMBER:
331880541
ADMINISTRATOR:OKORO, GERTRUDEFACILITY TYPE:
740
ADDRESS:42007 THOROUGHBRED LNTELEPHONE:
(951) 397-3369
CITY:MURRIETASTATE: CAZIP CODE:
92562
CAPACITY:6CENSUS: 4DATE:
02/12/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Administrator Gertrude OkoroTIME COMPLETED:
12:10 PM
ALLEGATION(S):
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Facility did not maintain a comfortable temperature for resident's in care
INVESTIGATION FINDINGS:
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On 2/12/2026, Licensing Program Analyst (LPA) Valerie Flores conducted an unannounced visit to the facility for the purpose of delivering the investigative findings into the allegation listed above. LPA Flores met with Administrator Gertrude Okoro and explained to Gertrude the purpose of the visit. The complaint investigation consisted of observations, interviews, and photos received.
Information received alleged that staff did not maintain a comfortable temperature for the residents in care. Witness #1 (W1) provided the department with a photo of the facility thermostat at 81 degrees Fahrenheit. Upon LPA’s subsequent visit to the facility, LPA observed the thermostat to be 81 degrees Fahrenheit. Interviews with (2) two out of (4) four residents reported that they often run cold and believe the facility to be cold despite staffs attempts to adjust the temperature. Resident #1 (R1) and Resident #3 (R3) report that when they are feeling cold, R1 and R3 will layer up with long sleeve shirts and/or a sweater.

(Continue to LIC9099AC: Unsubstanstaiated...)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 8
Control Number 18-AS-20250924084053
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: ROLLING GREEN SENIOR CARE
FACILITY NUMBER: 331880541
VISIT DATE: 02/12/2026
NARRATIVE
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(Continuation from LIC9099A: Unsubstantiated)

R1 reports that staff will at times offer the residents an additional blanket to keep warm. Interview with Resident #2 (R2) reports that they often run hot and facility has not made proper accommodations when they inform staff that they feel hot. R2 reports that the facility has provided a fan to R2 but does not find it to be accommodating as staff will not shut the windows. R2 reports that staff will not lower the air conditioning temperature for R2 when they request for the thermostat to be lowered. Resident #4 (R4) did not wish to answer LPA’s questions and LPA concluded the interview with R4. Interview with Staff #1 (S1) reported that the facility temperature will be set at 78 degrees Fahrenheit. S1 stated that when they learned that residents were cold, residents were assisted with putting on sweaters or covering up with blankets. S1 stated that when residents begin to run cold, staff will attempt to adjust the temperature to an appropriate temperature to what is suitable for the outside weather conditions and to be accommodating for every resident. S1 stated that R2 tends to run hot and they have provided R2 with a fan. S1 further explained that they do not lower the air conditioning for R2 as it would affect R1 and R3 as they run cold.

Therefore, the allegation of facility did not maintain a comfortable temperature for resident's in care is deemed unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are unsubstantiated at this time.

An exit interview was conducted where this report was discussed and provided to Administrator.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 8
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
09/24/2025 and conducted by Evaluator Valerie Flores
COMPLAINT CONTROL NUMBER: 18-AS-20250924084053

FACILITY NAME:ROLLING GREEN SENIOR CAREFACILITY NUMBER:
331880541
ADMINISTRATOR:OKORO, GERTRUDEFACILITY TYPE:
740
ADDRESS:42007 THOROUGHBRED LNTELEPHONE:
(951) 397-3369
CITY:MURRIETASTATE: CAZIP CODE:
92562
CAPACITY:6CENSUS: 4DATE:
02/12/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Administrator Gertrude OkoroTIME COMPLETED:
12:10 PM
ALLEGATION(S):
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Staff lock residents in their rooms
INVESTIGATION FINDINGS:
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***This is an amended version of the original report***
On 2/12/2026, Licensing Program Analyst (LPA) Valerie Flores conducted an unannounced visit to the facility for the purpose of delivering the investigative findings into the allegation listed above. LPA Flores met with Administrator Gertrude Okoro and explained to Gertrude the purpose of the visit. The complaint investigation consisted of observations, interviews, and records reviewed.
Information received alleged staff lock residents in their rooms. Interviews conducted with (4) four out of (4) four staff reported that staff have never locked residents in their rooms. An interview conducted with Witness #1 (W1) reported having concerns for Resident #4 (R4), explaining that if R4 was locked in their private room then R4 would not have the mental ability to open the door on their own. During LPA’s initial visit, LPA took photos of the locking mechanism. During a follow-up interview with W1, W1 confirmed that the locking mechanism was not changed and was the same locking mechanism W1 observed during their visit to the facility.
(Continue to LIC9099AC: Unsubstantiated)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 7 of 8
Control Number 18-AS-20250924084053
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: ROLLING GREEN SENIOR CARE
FACILITY NUMBER: 331880541
VISIT DATE: 02/12/2026
NARRATIVE
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(Continuation from LIC9099AC: Unsubstantiated)

A review of R4’s medical assessment does not report any mild cognitive intellectual disabilities. Through observations, LPA observed the bedroom doors to be equipped with a single sided deadbolt with the locking mechanism on the inside of the residents room with the key insert on the outside of the bedroom door. Through observations, the door could shut closed if the resident wanted privacy, the door can be pulled open by grabbing onto the deadbolts locking mechanism. Interviews with (2) two out of (2) two staff reported that residents have never been locked in their rooms.
Therefore, the allegation of staff lock residents in their rooms is deemed unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are unsubstantiated at this time.

An exit interview was conducted where this report was discussed and provided to Administrator.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
LIC9099 (FAS) - (06/04)
Page: 8 of 8