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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880810
Report Date: 09/30/2025
Date Signed: 09/30/2025 02:03:03 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
11/14/2022 and conducted by Evaluator Mary G Flores
COMPLAINT CONTROL NUMBER: 18-AS-20221114152101
FACILITY NAME:GREEN MERRYLANDS MURRIETA HOMEFACILITY NUMBER:
331880810
ADMINISTRATOR:ZHAO, NAFACILITY TYPE:
740
ADDRESS:40052 DAPHNE DRIVETELEPHONE:
(909) 994-6204
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY:6CENSUS: 4DATE:
09/30/2025
UNANNOUNCEDTIME BEGAN:
12:32 PM
MET WITH:Oswaldo Nunez - CaregiverTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff do not have running water for the residents
Facility is experiencing financial distress
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mary Flores conducted an unannounced subsequent complaint investigation visit regarding the above allegations. LPA Flores met with Oswaldo Nunez and explained the reason for the visit.

The investigation consisted of the following: On 11/17/22 LPA Arreola conducted an initial investigation visit. On 9/25/25 LPA Flores contacted the administrator and requested copies of bank statements for June through December of 2022, utility bill for July 2022, pertaining documents for resident #1. On 9/30/25 LPA Flores conducted a visit interviewed 4 residents, 1 staff, and conducted a tour of the facility.

The investigation revealed the following: Regarding allegation: Staff do not have running water for the residents. It is alleged resident was not able to flush toilet as there was no water at the facility. Interviews conducted with residents revealed there is running water, utilities, and meals are served to them at the facility. (CONTINUED ON LIC 9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2025
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 2
Control Number 18-AS-20221114152101
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: GREEN MERRYLANDS MURRIETA HOME
FACILITY NUMBER: 331880810
VISIT DATE: 09/30/2025
NARRATIVE
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Interviews conducted with staff revealed there are water services and utilities at the facility. Interview conducted with administrator/licensee revealed the facility has not had water services cut out and bills have been paid timely. There have been no interruptions in water services. On 11/26/22 LPA Arreola contacted Eastern Municipal Water District who stated the account was current and services were running at the facility. During today’s visit LPA observed running water in the bathrooms and kitchen.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Regarding allegation: Facility is experiencing financial distress. It is alleged the facility was unable to cover their bills. Interviews conducted with residents revealed meals have been provided 3 times a day, water, and electricity are available. Interviews conducted with staff revealed facility licensee/administrator ensures all utilities are available, food supplies are provided once a month for the month, and payroll is cover. LPA Flores reviewed the status of the licensee’s incorporation in the California Secretary of State website, it revealed that the licensee’s facility incorporation was suspended on 12/28/21 and back to active on 4/18/23. Per the licensee, the facility did not provide care to residents in 2021 due to COVID mandates and only provided services to resident #1 for two to three weeks during 2022. LPA reviewed bank statements provided, expenses and balance was observed between June 2022 to December of 2022. Based on the preponderance of evidence it cannot be established that they were in financial distress.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview was conducted with Oswaldo Nunez and a copy of this report was provided.
SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2025
LIC9099 (FAS) - (06/04)
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