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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881605
Report Date: 03/12/2026
Date Signed: 03/12/2026 01:48:35 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
08/14/2025 and conducted by Evaluator Seo Jeon
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20250814114558
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:
03/12/2026
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Arcita Cayabyab, AdministratorTIME COMPLETED:
02:10 PM
ALLEGATION(S):
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Staff left resident in soiled diapers for an extended period of time
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Seo Jeon 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 reviews of records.

On 08-14-2025, Community Care Licensing (The Department) received a complaint report with the following allegation.

It was alleged that staff left resident in soiled diapers for an extended period of time. Information received indicated that Resident #1 (R1) did not receive timely incontinence care. LPA conducted an interview with R1, who stated that R1 was receiving all necessary cares. R1 did not express any concerns with the facility services. LPA conducted interviews with two (2) other residents, all of whom denied ever being neglected by staff. LPA attempted to conduct interviews with two (2) additional residents but was unsuccessful due to their cognitive condition. Continued on LIC9099-C....
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Seo Jeon
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
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-20250814114558
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: 03/12/2026
NARRATIVE
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LPA conducted an interview with one (1) staff member who stated room check has been done every 1 to 2 hours for all residents. On one occasion, two (2) staff members stayed with R1 all night due to R1's behavior.

Based on records review and interviews conducted, 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: 03/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2