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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881526
Report Date: 03/04/2026
Date Signed: 03/04/2026 11:33:13 AM

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
07/30/2025 and conducted by Evaluator Venus Mixson
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20250730134050
FACILITY NAME:IRIS FAMILY HOME CAREFACILITY NUMBER:
331881526
ADMINISTRATOR:KINCHERLOW, JACQUELINE IFACILITY TYPE:
740
ADDRESS:1712 BRIDLE TRAILTELEPHONE:
(951) 665-6092
CITY:SAN JACINTOSTATE: CAZIP CODE:
92582
CAPACITY:5CENSUS: 3DATE:
03/04/2026
UNANNOUNCEDTIME BEGAN:
10:48 AM
MET WITH:ADMINISTRATOR, JACQUELINE KINCHERLOW TIME COMPLETED:
11:44 AM
ALLEGATION(S):
1
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3
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5
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7
8
9
Staff do not provide activities for resident
INVESTIGATION FINDINGS:
1
2
3
4
5
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7
8
9
10
11
12
13
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 allegation.
On July 30, 2025, Community Care Licensing received a complaint alleging staff do not provide activities for residents. Information obtained from an interview with Licensee revealed the allegation was false. Licensee indicated the facility has scheduled activities and provided LPA with a copy of an activities calendar. Information obtained through interviews with additional staff revealed residents are able to engage or refuse to participate in activities. It was stated activities included music therapy, reading, exercise classes, and games. It was also stated the facility offers structured and individualized activities as well. It was stated that activities are tailored to residents’ abilities and interests. Information received from interviews with three of three residents indicated facility staff provides activities for all residents in care. Additionally, resident interviews indicated activities are decided and suggested by the residents. Information received from interviews with Additional Witnesses, which are residents’ responsible parties, stated facility staff do provide activities for residents and there are no concerns. Information obtained from interview with Witness, Hospice Nurse assigned to one of the residents, indicated they have been present while residents were participating in activities. During the inspection, on February 17, 2026, LPA observed two of three residents participating in a trivia game and exercise class. LPA’s observations confirmed information documented on the facilities activities schedule. LPA observed the activities calendar to be posted at the facility on several unannounced visits, 08/06/2025, and again on 02/17/2026.
Based on information obtained from interviews, record reviews, and observations, the evidence received pertaining to the allegation that staff do not provide activities for residents was deemed unfounded. An unfounded finding indicates that the allegation is false, could not have happened, or is without a reasonable basis. This allegation has been dismissed.
An exit interview was conducted. A copy of this report was discussed and given to the Administrator, Jacqueline Kincherlow.
Unfounded
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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