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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880776
Report Date: 06/28/2025
Date Signed: 06/28/2025 04:22:46 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
04/13/2023 and conducted by Evaluator Antonine Richard
COMPLAINT CONTROL NUMBER: 18-AS-20230413163515
FACILITY NAME:WESTMONT VILLAGEFACILITY NUMBER:
331880776
ADMINISTRATOR:VIVIAN VILLEGASFACILITY TYPE:
740
ADDRESS:17050 ARNOLD DRIVETELEPHONE:
(951) 697-2100
CITY:RIVERSIDESTATE: CAZIP CODE:
92518
CAPACITY:225CENSUS: 174DATE:
06/28/2025
UNANNOUNCEDTIME BEGAN:
07:52 AM
MET WITH:Allicia BallardTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff do not provide adequate food service to residents.
INVESTIGATION FINDINGS:
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On 06/28/25, at 8:00 am, Licensing Program Analyst (LPA) Antonine Richard conducted an initial complaint visit regarding the allegation above. LPA met with Alicia Ballard, the Memory Care Director (MCD), and explained the purpose of today’s visit. LPA and MCD toured the facility inside and outside.

The investigation consisted of the following: On June 28, 2025, LPA Richard reviewed and obtained copies of the resident roster (dated June 1, 2025, to June 26, 2025), the staff roster (dated June 1, 2025, to June 26, 2025), and facility menus (dated June 8, 2025, to July 5, 2025). Additionally, LPA requested and obtained copies of specific documents for Resident #1 (R1), including the admission agreement (dated January 31, 2022), the emergency ID form, the physician's report (dated January 26, 2022), and the needs of services plan (dated August 24, 2023). On June 28, 2025, LPA Richard conducted a tour of the kitchen and observed the lunch service from 11:15 AM to 11:30 AM. Between 10:30 AM and 12:00 PM on the same day, LPA interviewed six staff members (S1-S6). Later, between 1:30 PM and 3:00 PM, LPA interviewed six residents (R2-R7).
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2025
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-20230413163515
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: WESTMONT VILLAGE
FACILITY NUMBER: 331880776
VISIT DATE: 06/28/2025
NARRATIVE
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Allegation: Staff do not provide adequate food service to residents.

The complaint alleges that the residents have to wait two hours for their food, which is often served cold. On June 28, 2025, between 10:00 AM and 10:20 AM, the Licensing Program Analyst (LPA) interviewed the Memory Care Director (MCD), who denied the allegation, stating that food is served on hot plates. The MCD also mentioned that residents rarely complain to the kitchen staff about the food being cold or too hot. Additionally, the facility does not allow microwaves in any of the residents' rooms in the Memory Care unit, except in the dining area.

Later on, June 28, between 10:30 AM and 12:00 PM, the LPA interviewed six staff members (S1-S6). Four out of the six staff members denied the allegation, asserting that they are aware food is served on hot plates. They also mentioned that if a resident requests reheating, the kitchen staff would accommodate this, although it happens rarely.

Furthermore, on the same day, between 1:30 PM and 3:00 PM, the LPA interviewed six residents (R2-R7). All six residents denied the complaint, stating that the food served to them is always hot and does not need reheating. However, they confirmed that if they wanted to warm up their food, the staff would assist them. Between 1:00 PM, LPA Richard reviewed the facility's menu, dated from June 8, 2025, to July 5, 2025, which showed that there were various food options available.

Evaluation Report Continues LIC9099-C

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20230413163515
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: WESTMONT VILLAGE
FACILITY NUMBER: 331880776
VISIT DATE: 06/28/2025
NARRATIVE
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On June 28, between 11:15 AM and 11:30 AM, LPA conducted a tour of the kitchen and dining room, where LPA observed that lunch had been served, was hot, and of good quality. Unfortunately, LPA could not interview Resident #1 because R1 was no longer residing in the facility.

Based on LPA observations, interviews, and record reviews, LPA did not find sufficient evidence to support the allegation that the staff do not provide adequate food service to residents. Although the allegation may have happened or is valid, there is not enough preponderance of evidence to prove that it is valid or did occur; therefore, the allegation is Unsubstantiated.

No deficiencies were cited.

An exit interview was conducted and a copy of the report was provided to Executive Director Judith Pierfax.

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3