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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881605
Report Date: 01/28/2026
Date Signed: 01/28/2026 10:58:42 AM

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
01/15/2026 and conducted by Evaluator Seo Jeon
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20260115084556
FACILITY NAME:CYPRESS SPRINGS HOMECAREFACILITY NUMBER:
331881605
ADMINISTRATOR:NUGUID, SUSAN LFACILITY TYPE:
740
ADDRESS:68905 HERMOSILLO ROADTELEPHONE:
(760) 459-3214
CITY:CATHEDRAL CITYSTATE: CAZIP CODE:
92234
CAPACITY:6CENSUS: 5DATE:
01/28/2026
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Arcita Cayabyab, AdministratorTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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Staff are not ensuring that the needs of the resident in care are being met.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Seo Jeon and Ahliah Sharp conducted an unannounced visit to the facility to deliver findings of the above allegation. LPA met with Arcita Cayabyab, Administrator. The Department investigation involved interviews with staff and residents and review of records.

On 01-15-2026, Community Care Licensing (The Department) received a complaint report with the following allegation.

It was alleged that staff are not ensuring that the needs of the resident in care are being met. Information received indicated that staff became upset and withheld care, such as shower service and incontinence care to residents.

Continued on LIC9099-C....
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Seo Jeon
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
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-20260115084556
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: CYPRESS SPRINGS HOMECARE
FACILITY NUMBER: 331881605
VISIT DATE: 01/28/2026
NARRATIVE
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LPA conducted interviews with Resident #1 (R1), but only limited information was obtained due to R1’s inability to express themselves. LPA conducted interviews with another two (2) residents, all of whom stated they have received all the care from the facility staff. LPA’s attempted interviews with another two (2) residents were unsuccessful due to their cognitive condition. LPA conducted interviews with two (2) staff members, all of whom denied ever withholding care to residents.

Based on interviews conducted, the Department’s investigation did not find enough information to corroborate the allegation that staff are not ensuring that the needs of the resident in care are being met. This allegation is unsubstantiated.

A finding that the complaint is UNSUBSTANTIATED means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.



An exit interview was conducted where a copy of this report was provided.
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Seo Jeon
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2