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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881368
Report Date: 03/25/2026
Date Signed: 03/25/2026 10:42:40 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
03/24/2026 and conducted by Evaluator Mia Lankford
COMPLAINT CONTROL NUMBER: 18-AS-20260324134640
FACILITY NAME:LEGACY OF HEMET 1, THEFACILITY NUMBER:
331881368
ADMINISTRATOR:KELLOGG, MICHELLEFACILITY TYPE:
740
ADDRESS:320 S SAN JACINTO STTELEPHONE:
(951) 765-1840
CITY:HEMETSTATE: CAZIP CODE:
92543
CAPACITY:16CENSUS: DATE:
03/25/2026
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Prescila Brown- AdministratorTIME COMPLETED:
10:50 AM
ALLEGATION(S):
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Facility does not have sufficient food for the residents in care.
INVESTIGATION FINDINGS:
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On March 25, 2026, Lisencing Program Analysts (LPAs) Mia Lankford and Jarred Torres arrived at the facility unannounced and was greeted by Administrator, Prescila Brown. The LPAs explained the purpose of the visit.

LPAs conducted a tour of the facility along with the Administrator and made Health and Safety observations pertaining to the listed allegation. Based on observation, the food supply does not meet the Title 22 Regulations. LPAs explained to Administrator that this investigation includes a deficiency 87555 (b)(26), which was issued during the visit.

An exit interview was conducted, and a copy of this report, LIC 9099, LIC 9099-D, and Appeal Rights discussed and provided to Administrator, Prescila Brown.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Mia Lankford
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2026
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-20260324134640
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: LEGACY OF HEMET 1, THE
FACILITY NUMBER: 331881368
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/25/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/25/2026
Section Cited
CCR
87555(b)(26)
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87555(b)(26) General Food Service Requirements
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Administrator will provide grocery receipts by the end of 3/25/26
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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: Mia Lankford
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2