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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881421
Report Date: 07/18/2025
Date Signed: 07/18/2025 12:46:54 PM

Unsubstantiated


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
09/11/2024 and conducted by Evaluator Abdoulaye Zerbo
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240911142008
FACILITY NAME:SMITH ROAD ASSISTED LIVINGFACILITY NUMBER:
331881421
ADMINISTRATOR:LECITA, MA SATCHELFACILITY TYPE:
740
ADDRESS:753 SMITH ROADTELEPHONE:
(951) 927-8178
CITY:HEMETSTATE: CAZIP CODE:
92544
CAPACITY:12CENSUS: 9DATE:
07/18/2025
UNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Edith CamposTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Facility staff neglect resulted in resident sustaining bed sores
Facility staff are not bathing resident
Staff are financially abusing residents in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an unannounced visit to deliver findings for the allegations listed above. LPA Abdoulaye was greeted and granted entrance by Caregiver Edith Campos. LPA Abdoulaye Zerbo identified himself and discussed the purpose of the visit.

It was alleged that facility staff neglect resulted in Resident 1 (R1) sustaining bed sores. Concerns were made that R1 did not receive appropriate care, which resulted in R1 sustaining bedsores. A review of R1’s medical records, facility file, and care logs were completed. The information obtained revealed that R1 is regularly assisted by staff and is changed at least six times a day, as confirmed by staff members. Further information obtained from interviews revealed that R1 arrived at the facility with a spreadable health condition and not bed sores. Facility representatives stated after medical evaluation, it was determined that R1 would go to a Skilled Nursing Facility for further treatment. Facility representatives stated they were not equipped to retain R1 after it was determined the spreadable health condition was contagious. After the treatment, R1 returned to the facility where adequate care was provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Abdoulaye Zerbo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2025
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 18-AS-20240911142008
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: SMITH ROAD ASSISTED LIVING
FACILITY NUMBER: 331881421
VISIT DATE: 07/18/2025
NARRATIVE
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It was alleged that facility staff are not bathing R1. Concerns were expressed R1 is not being bathed, according to information obtained, R1 is supposed to be getting bathed once or twice a week. According to interview statements obtained, staff are utilizing body wipes instead of bathing/showering R1. LPA conducted an interview with R1, and information obtained revealed R1 receives a bath once a week on Saturdays, which aligns with the facility’s records. Interviews with staff confirmed that R1 receives baths three times a week, once by facility staff and twice by R1’s nurse aide. Additionally, information obtained through interviews revealed R1 is regularly assisted by staff and is changed at least six times a day, as confirmed by staff members.

It was alleged that staff are financially abusing residents in care. Concerns were made that the licensee uses the residents EBT card to make purchases. LPA Abdoulaye Zerbo interviewed several residents regarding their financial management. The information obtained from the interviews revealed that residents manage their own money and for some residents, their money is managed by responsible parties and/or family members.

Based on the evidence, the allegations mentioned above are UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated at this time.

An exit interview was conducted where this report, LIC9099 was discussed and provided to Administrator Ma Satchel Lecita

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Abdoulaye Zerbo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2