<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880838
Report Date: 09/25/2025
Date Signed: 09/25/2025 11:31:49 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/26/2023 and conducted by Evaluator Javier Prieto
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20231226135432
FACILITY NAME:EMK RESIDENTIAL CARE FOR ELDERLYFACILITY NUMBER:
331880838
ADMINISTRATOR:PANALIGAN, MARILOUFACILITY TYPE:
740
ADDRESS:7750 BOLERO DRIVETELEPHONE:
(951) 332-0558
CITY:RIVERSIDESTATE: CAZIP CODE:
92509
CAPACITY:6CENSUS: 6DATE:
09/25/2025
UNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Elisa See, staffTIME COMPLETED:
11:40 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident in care was not provided meals in a timely manner.

Staff did not provide proper medication assistance to resident in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conclude a complaint investigation regarding the allegations made in this complaint. LPA Prieto met with Ms See and explained the elements of the complaint.

Allegation #1 - LPA interviewed resident #1 (R1), R2, R3, R4 at the facility, all stating that they are receiving three (3) meals a day and those meals are being served in a timely manner. Interview with staff #1 (S1), states that meals are served during appropriate hours for breakfast , lunch and dinner.

Allegation #2 - LPA interviewed resident #1 (R1), R2, R3, R4 at the facility, all stating that they are having their medication dispensed accordingly and as prescribed. S1 states all medication are being dispensed accordingly and as prescribed.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
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 56-AS-20231226135432
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME: EMK RESIDENTIAL CARE FOR ELDERLY
FACILITY NUMBER: 331880838
VISIT DATE: 09/25/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on the information obtained there is not enough evidence to support the allegations made in this complaint. Therefore, the allegations are deemed UNSUBSTANTIATED at this time. This report was signed by LPA Prieto and Ms See and a copy was left with the facility.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2