336426083-4-23-2026-18-AS-CTUA-DTMSKM-20260430135659

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336426083
Report Date: 04/23/2026
Date Signed: 04/23/2026 01:09:33 PM

Unfounded

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
04/17/2026 and conducted by Evaluator Janette Romero

COMPLAINT CONTROL NUMBER: 18-AS-20260417154421

FACILITY NAME:	ATRIA PARK OF VINTAGE HILLS		FACILITY NUMBER:	336426083
ADMINISTRATOR:	MARIANO Q. HERNANDEZ		FACILITY TYPE:	740
ADDRESS:	41780 BUTTERFIELD STAGE RD		TELEPHONE:	(951) 506-5555
CITY:	TEMECULA	STATE: CA	ZIP CODE:	92592
CAPACITY:	143	CENSUS: 110	DATE:	04/23/2026
		UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Business Director Laura Sutterman		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Staff did not safeguard Resident 1's personal belongings

INVESTIGATION FINDINGS:

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On 04/23/2026, Licensing Program Analyst (LPA) Janette Romero conducted an unannounced visit to the facility to investigate the allegation listed above. LPA met with Business Director (BS) Laura Sutterman and Resident Services Director (RSD) Karina Cortez who were informed of the purpose of the visit.

LPA toured the facility with RSD Cortez, conducted interviews, and obtained copies of pertinent records. Regarding the allegation, "Staff did not safeguard Resident 1's personal belongings" it was alleged that an individual from an outside agency stole Resident 1's (R1's) antique dishes and social security card. LPA made multiple unsuccessful attempts to make contact with the reporting party for additional information.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE:	DATE: 04/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2026

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-20260417154421

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: ATRIA PARK OF VINTAGE HILLS	FACILITY NUMBER: 336426083
	VISIT DATE: 04/23/2026

NARRATIVE

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LPA reviewed R1's medical assessment dated 04/06/2026, documenting R1 does not exhibit memory loss or disorientation, and has the capacity to manage, administer, and store their own medications. LPA also reviewed R1's admission agreement dated 04/06/2026 noting the resident is responsible for insuring and maintaining their own clothing, jewelry, and personal possessions. LPA reviewed a signed Client/Resident Personal Property and Valuables (LIC 621) dated 04/06/2026 and the "Description" column states, "Nothing to declare at this time" and reflects a signature of R1's responsible person.

BD Sutterman was interviewed and reported R1 physically moved into the facility on 04/10/2026 and has not received any visits from an outside agency since their admission. RSD Cortez was also interviewed and reported the facility does not safeguard any of the residents personal belongings or cash resources. RSD Cortez reported R1 has not receive any services from home health, hospice, or any outside agency since being admitted to the facility. BD and RSD reported no such alleged incident has occurred in the facility.

LPA conducted an interview with R1 who reported the incident occurred in their private residence prior to being admitted into the facility. R1 reported facility staff had no involvement with the incident and the facility does not safeguard any of their personal belongings. LPA conducted an interview with R1's responsible person who corroborated the information provided by R1. R1's responsible person reported they do not have any concerns with the care and supervision R! has received in the facility. This agency has investigated the complaint alleging "Staff did not safeguard Resident 1's personal belongings". We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. An exit interview was conducted, and a copy of this report and Confidential Names list (LIC 811) was reviewed and provided to BD Sutterman.

SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE:	DATE: 04/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2026

LIC9099 (FAS) - (06/04)

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