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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880722
Report Date: 08/22/2024
Date Signed: 12/05/2024 02:28:27 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
01/31/2024 and conducted by Evaluator Stephanie Martinez
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240131082100
FACILITY NAME:DESERT HILLS MEMORY CARE CENTERFACILITY NUMBER:
331880722
ADMINISTRATOR:HUDSON, CHANTELLEFACILITY TYPE:
740
ADDRESS:25818 COLUMBIA STTELEPHONE:
(951) 652-1837
CITY:HEMETSTATE: CAZIP CODE:
92544
CAPACITY:58CENSUS: 42DATE:
08/22/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Shannon Moore Wilkerson, AdministratorTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Facility retaining residents who need a higher level of care.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs), Stephanie Martinez and Ferrer Sabarias, conducted an unannounced visit to the facility to deliver the findings of the investigation into the above allegation. The LPAs met with Administrator, Shannon Moore Wilkerson, and informed her of the purpose of the visit. A report was received by the Department alleging the licensee admits residents into the facility who have a mental disorder requiring a higher level of care than can be met by the facility. The investigation included staff interviews, review of records and collection of relevant documentation. An interview with a witness revealed there are at least two residents in care who do have a mental disorder requiring a higher level of care. LPA Martinez reviewed the medical assessments (Physicians Report for Residential Care Facility for The Elderly) for both residents identified, Resident One (R1) and Resident Two (R2). Neither report noted either R1 or R2 were diagnosed with a mental disorder as alleged by the witness. Interviews were conducted with the offices of the medical providers for both residents. A representative for R1's Physician reported that R1 is diagnosed with a mental disorder, despite the signed physician's report not identifying the specific condition. The Physician for R2 reported they were unaware of any mental health condition the resident was alleged to have had. Therefore, due to conflicting information, this allegation is deemed UNSUBSTANTIATED at this time. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. This report was reviewed with the Administrator and a copy was provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Stephanie Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
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-20240131082100
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: DESERT HILLS MEMORY CARE CENTER
FACILITY NUMBER: 331880722
VISIT DATE: 08/22/2024
NARRATIVE
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THIS PAGE WAS INTENTIONALLY LEFT BLANK.
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Stephanie Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2