331881073-2-19-2025-18-AS-JDHS-DE4T5P-20250221132548

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331881073
Report Date: 02/19/2025
Date Signed: 02/19/2025 03:44:19 PM

Unfounded

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
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/22/2022 and conducted by Evaluator Yolanda Delgado

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20220422163744

FACILITY NAME:	PACIFICA SENIOR LIVING MENIFEE		FACILITY NUMBER:	331881073
ADMINISTRATOR:	LETH, RANCE		FACILITY TYPE:	740
ADDRESS:	28333 VALLEY BOULEVARD		TELEPHONE:	(951) 679-8811
CITY:	SUN CITY	STATE: CA	ZIP CODE:	92586
CAPACITY:	220	CENSUS: 210	DATE:	02/19/2025
		UNANNOUNCED	TIME BEGAN:	03:10 PM
MET WITH:	Rance Leth, Executive Director		TIME COMPLETED:	03:37 PM

ALLEGATION(S):

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Staff stole resident's bank statements.
Resident does not have access to a phone.
Facility overcharged resident for services.

INVESTIGATION FINDINGS:

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Licensing Program Analyst, (LPA) Yolanda Delgado arrived unannounced to the facility to conclude an investigation pertaining to the allegations listed above. LPA met with Executive Director Rance Leth and explained the purpose of the visit.

On April 22, 2022, Community Care Licensing received a complaint alleging staff stole resident’s bank statements, resident does not have access to a phone, and facility overcharged resident for services. LPA conducted interviews with Administrator, staff, residents, and additional witnesses. LPA also conducted a review of pertinent documentation.

Regarding the allegation staff stole resident’s bank statements, it was reported that Administrator went into client’s room and stole bank statements. It was also reported that Administrator is taking money from Resident. Information obtained from the interview with Administrator denied that they retrieved any resident’s
(Continued on Page 2)

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Yolanda Delgado
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

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-20220422163744

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
RIVERSIDE, CA 92507

FACILITY NAME: PACIFICA SENIOR LIVING MENIFEE	FACILITY NUMBER: 331881073
	VISIT DATE: 02/19/2025

NARRATIVE

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(Continued from Page 1)
bank statements and is taking any money from Resident.

It was reported that Resident is responsible for their own finances. Information obtained from interview with Resident could not verify exact details of resident’s bank statements that were taken. Information obtained from an interview with an additional witness stated that staff did not steal Resident’s bank statements It was stated that Resident was in possession of all their banking information. It was further stated that there were no concerns regarding theft of Resident’s money or property.

In regard to the allegation that Resident does not have access to a phone, it was reported that Resident is not allowed to use the phone. Information obtained from Administrator, indicated that Resident had access to a facility and mobile phone. It was advised that Resident was able to communicate with family when and as often as they desired. Interview with Administrator stated that two phones are available for any resident to use, and it is located at the front desk and the conference room for private calls. Information obtained from interview with Resident stated that a personal mobile phone can be used at any time. Information obtained from additional witnesses stated that Resident was able to speak with family and always had access to a phone.

In regard to the allegation that facility overcharged resident for services, it was reported that Administrator charges Resident more than what was the admissions agreement indicates. Information obtained from interviews with Administrator stated that Resident’s Room Rate, Assisted Living Care Charge, laundry and cable services rate remained the same. It was advised that the Second Occupancy Rate increased to $50 on January 1, 2022. Information obtained from interview with Resident stated that charges were being billed and resident could not verify what the charges were. Information obtained from interview with an additional witness stated the facility was charging Resident as appropriate for the services. LPA conducted a review of resident’s admission agreement and assessments. All documents notifying of the increase were signed by resident.

Based on staff interviews, resident interviews, witnesses’ interviews, facility records, resident files, the allegations staff stole resident’s bank statements, resident does not have access to a phone, and facility overcharged resident for services is Unfounded.
(Continued on Page 3)

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Yolanda Delgado
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 18-AS-20220422163744

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
RIVERSIDE, CA 92507

FACILITY NAME: PACIFICA SENIOR LIVING MENIFEE	FACILITY NUMBER: 331881073
	VISIT DATE: 02/19/2025

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	(Continued from Page 2) meaning that the allegation was false, could not have happened and/or is without a reasonable basis. An exit interview was conducted with Rance Leth and a copy of this report along with LIC811- Confidential Names list was provided.

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Yolanda Delgado
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 3