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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880810
Report Date: 10/10/2025
Date Signed: 10/10/2025 10:30:56 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
02/13/2025 and conducted by Evaluator Armando Perez
COMPLAINT CONTROL NUMBER: 18-AS-20250213102134
FACILITY NAME:GREEN MERRYLANDS MURRIETA HOMEFACILITY NUMBER:
331880810
ADMINISTRATOR:BRANDON MARQUEZFACILITY TYPE:
740
ADDRESS:40052 DAPHNE DRIVETELEPHONE:
(909) 994-6204
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY:6CENSUS: 5DATE:
10/10/2025
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Caregiver Osvaldo NunezTIME COMPLETED:
10:40 AM
ALLEGATION(S):
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Staff are not able to communicate effectively with residents in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Armando Perez, conducted an unannounced visit to deliver findings for a complaint investigation regarding the above allegation. LPA Perez met with Caregiver Osvaldo Nunez, where the LPA explained the purpose of the visit and the elements of the allegation. LPA contacted Administrator Brandon Marquez by telephone and was notified of the purpose of the visit.The investigation consisted of interviews with staff and witnesses and file reviews.

On February 13, 2025, Community Care Licensing Division (CCLD) received a complaint alleging that staff are not able to communicate effectively with residents in care. It was alleged that Staff 1 (S1) lacked the ability to communicate effectively in a language understood by the residents. The allegation raised concerns about S1’s ability to provide essential services and respond appropriately in emergency situations. Interview with Administrator, Sandy Zhao revealed that S1 was not fluent in English, however, they reported S1 could comprehend and communicate in order to provide care and supervision.
Continued on LIC 9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Armando Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2025
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-20250213102134
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: 10/10/2025
NARRATIVE
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Additionally, Sandy corroborated that S1 was encouraged to use translator tools when they needed to understand more complex conversations. Information obtained from resident interviews revealed that 2 out of 5 individuals experienced difficulty communicating with S1. Residents reported that S1 was unable to communicate effectively, noting that their requests were often misunderstood or disregarded. Interview with Additional Witness 1 (AW1), it was reported they observed S1 unable to communicate with the residents in care throughout their visit. AW1 further stated that during the exit interview, S1 relied on a translator device and did not verbally acknowledge AW1 to confirm their understanding of the information provided. AW1 further noted that, based on the interaction, it was unclear whether S1 would be capable of effectively communicating and responding properly in the event of an emergency. LPA was unable to interview S1 due to their resignation in February 2025 and their inability to contact them.

Through file reviews, information obtained revealed that the Plan of Operation includes a Job Description stating that staff must be able to interact professionally and respectfully with residents, visitors, licensing agents, and other community agencies.

Based on interviews and record reviews, the allegation that staff are not able to communicate effectively with residents in care is substantiated. A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met. This poses a health and safety and or personal rights risk to residents in care. The facility will be cited.

An exit interview was conducted. A copy of this report was provided to facility representative Osvaldo Nunez, along with a copy of the LIC9099-C, LIC9099D, and Appeal Rights were provided.

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Armando Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20250213102134
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/10/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/31/2025
Section Cited
CCR
87411(d)(3)
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87411(d)(3)Personnel Requirements(d)All personnel shall be given on the job training…for the job assigned and as evidenced by safe and effective job performance:(3)Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents.
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The licensee confirmed S1 resigned. To prevent recurrence of deficiency, the facility will implement staff training focused on residents' personal rights and the facility's emergency procedures policy. Licensee will email proof of the training conducted with all employees by POC due date.
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This requirement is not met as evidenced by: Based on records and interviews, Licensee did not ensure that 1 of 6 staff (S1) had the skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents.
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This posed a potential health, safety, and personal rights risk to residents 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: Jazmond D Harris
LICENSING EVALUATOR NAME: Armando Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2025
LIC9099 (FAS) - (06/04)
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