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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336407734
Report Date: 05/14/2025
Date Signed: 05/14/2025 02:23:40 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
05/12/2025 and conducted by Evaluator Janira Arreola
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20250512145014

FACILITY NAME:PICO DE LOROFACILITY NUMBER:
336407734
ADMINISTRATOR:VIVIEN RILLO/EFREN RILLOFACILITY TYPE:
740
ADDRESS:620 NORTH PERRIS BLVDTELEPHONE:
(951) 943-8081
CITY:PERRISSTATE: CAZIP CODE:
92571
CAPACITY:45CENSUS: DATE:
05/14/2025
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Administrator, Yamberly Genesis GarciaTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff are disclosing personal information about the residents
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced to the facility in order to conduct an investigation into the above allegation. LPA met with Administrator, Yamberly Genesis Garcia and spoke with Licensee Viven Rilo over the phone who were informed on the purpose of the visit. LPA conducted interviews and records review.

It was alleged "Staff are disclosing personal information about the residents." It was alleged staff speak to others about Resident #1 (R1)'s personal information including those who was not R1's legal representative.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 18-AS-20250512145014
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: PICO DE LORO
FACILITY NUMBER: 336407734
VISIT DATE: 05/14/2025
NARRATIVE
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LPA conducted interviews with (5) facility staff who denied they disclose personal information on R1 to others outside the facility. (5) of (5) staff revealed they communicate to R1's legal representative (Power of Attorney POA), and R1's doctors. (2) of (5) staff revealed R1 has a POA but did not have supporting documents in R1's file.

Interview with R1 confirmed the identity of their POA. R1 stated they did not know if staff was disclosing their personal information to others.

Therefore, the allegation that staff speak about R1 to others on R1's personal information is unsubstantiated. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4