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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881033
Report Date: 12/02/2025
Date Signed: 12/02/2025 12:34:25 PM

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
12/01/2025 and conducted by Evaluator Javier Prieto
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20251201131529
FACILITY NAME:ROYALTY SENIOR LIVINGFACILITY NUMBER:
331881033
ADMINISTRATOR:RILEY, TA'NEISHAFACILITY TYPE:
740
ADDRESS:10104 KINGS CTTELEPHONE:
(951) 416-1064
CITY:JURUPA VALLEYSTATE: CAZIP CODE:
92509
CAPACITY:6CENSUS: 4DATE:
12/02/2025
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Facility-Administrator-Ta'neisha RileyTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Staff denied a resident's authorized representative from calling the facility
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint investigation regarding the above allegation. LPA Prieto met with Facility-Administrator-Ta'neisha Riley and explained the elements of the complaint.

Allegation #1 - Administrator Riley (S1) explained to LPA the facility phone is available for all residents in the home. Facility phone is a handheld phone capable of receiving and making calls. This phone does not have the capability of blocking calls. LPA spoke resident #1 (R1) who state she receives calls from family members on the facility and capable of making and declining calls on her own. R1 states staff has never denied her incoming calls to the facility. LPA observed facility phone call list which indicate calls made to this phone. None of the numbers listed indicate that they were block. These numbers were obtained for this complaint during this investigation.
*** continued on LIC 9099C***

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
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-20251201131529
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: ROYALTY SENIOR LIVING
FACILITY NUMBER: 331881033
VISIT DATE: 12/02/2025
NARRATIVE
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Based on the information obtained there is not enough evidence to support the allegation made in this complaint. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. This report was signed by LPA Prieto and Administrator Riley and a copy was left with the facility.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2