331881526-3-4-2026-18-AS-JDHS-DS8M27-20260316091259

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331881526
Report Date: 03/04/2026
Date Signed: 03/04/2026 05:48:05 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
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/30/2025 and conducted by Evaluator Venus Mixson

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20250730134050

FACILITY NAME:	IRIS FAMILY HOME CARE		FACILITY NUMBER:	331881526
ADMINISTRATOR:	KINCHERLOW, JACQUELINE I		FACILITY TYPE:	740
ADDRESS:	1712 BRIDLE TRAIL		TELEPHONE:	(951) 665-6092
CITY:	SAN JACINTO	STATE: CA	ZIP CODE:	92582
CAPACITY:	5	CENSUS: 3	DATE:	03/04/2026
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	ADMINISTRATOR, JACQUELINE I KINCHERLOW		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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Staff are using cameras in residents rooms.
Staff leave residents in bed during the day.

INVESTIGATION FINDINGS:

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On March 04, 2026, Licensing Program Analyst (LPA), Venus Mixson arrived unannounced at the facility and met with the Administrator, Jacqueline Kincherlow. LPA explained the reason for the visit was to provide findings for the complaint investigation. During the investigation, LPA conducted interviews, record reviews, and made observations pertaining to the listed allegations.
On July 30, 2025, Community Care Licensing received a complaint alleging staff are using cameras in residents’ room with video/sound, and staff leave residents in bed during the day. Regarding the Allegation:Staff are using cameras in residents rooms; it was reported there were cameras in each of the three resident’s bedrooms with video and sound capability. Information obtained from an interview with the Licensee revealed they denied the allegation. Licensee indicated that the device is not being used by the facility as a camera, but as a motion detector. Licensee indicated that the device was being used to assist with acknowledging and reviewing falls and providing attention in a timely manner. Licensee also advised that the monitor does not have a SIM card, therefore; the device is unable to record. Licensee stated residents and their authorized parties were made aware at the time of admission that a device is placed in resident’s bedrooms. Information obtained from an interview with staff revealed the device does have video and audio capability with the utilization of the SIM card. Information obtained from interviews with three of three residents revealed during the admission process, they were advised there were devices in the resident’s bedrooms that assist with monitoring movement and motion. Three of three residents were not advised the devices had video and audio capability. Information obtained from interviews with Additional Witnesses, that were residents’ responsible parties, confirmed they were aware of the devices in the bedrooms but were not informed the devices had video and audio capability.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 18-AS-20250730134050

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: IRIS FAMILY HOME CARE	FACILITY NUMBER: 331881526
	VISIT DATE: 03/04/2026

NARRATIVE

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LPA's review of the records, including three of three of the residents “Acknowledgment & Consent Forms,” signed and dated by residents and their responsible parties, revealed that they (Acknowledge and Consent to the use of the facilities fall and prevention of a non-recording baby monitor in each of the resident’s rooms. The information obtained from the review of documentation revealed that residents and their authorized representatives were advised of a monitoring device in each of the resident’s room.
Regarding the allegation, Staff leave residents in bed during the day; it was reported that residents were observed to be in bed at approximately 1:00pm. It was further reported residents are required to eat meals in their bed. Licensee denied the allegation. Licensee stated facility staff do not leave residents in bed during the day and residents do not have to eat their meals in their bed. Licensee stated residents can be in bed if the residents choose. Licensee stated residents eat their meals in the designated dining area, unless the resident chooses not to. Information obtained from an interview with an additional staff member indicated they do not leave residents in bed during the day and residents are transferred out of bed daily for meals and other activities. Information obtained from interviews with three of three residents, indicated the facility staff do attend to their daily needs and assist with transferring out of bed. None of the residents expressed any concerns with staff leaving them in bed during the day or being forced to eat in their rooms. Information obtained from additional witnesses, the residents Responsible Parties revealed that they saw their family member up and out of bed while visiting. Information obtained from an interview with Hospice Nurse indicated that they were at the facility twice a week and observed staff getting residents out of bed for meals and activities.
Based on information obtained from interviews, record reviews, and observations, the evidence received pertaining to the allegation that staff are using cameras in residents’ rooms with video and audio capability, and staff leave residents in bed during the day, did not meet the preponderance of the evidence standard and therefore, has been deemed unsubstantiated. An unsubstantiated allegation means that the preponderance of the evidence standard has not been met. An exit interview was conducted, and a copy of this report was discussed and given to the Administrator,Jacqueline Kincherlow.

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2026

LIC9099 (FAS) - (06/04)

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