Complaint Investigation Report

331881569-9-4-2025-18-AS-APEZ-DPASV8-20251212131220

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

RIVERSIDE ASC , 1650 SPRUCE ST STE 200 MS29-27

This is an official report of an unannounced visit/investigation of a complaint received in our office on

08/30/2025 and conducted by Evaluator Abdoulaye Zerbo

COMPLAINT CONTROL NUMBER: 18-AS-20250830130845

Licensing Program Analyst (LPA), Abdoulaye Zerbo conducted an unannounced visit to the facility to investigate the allegations listed above. LPA met with Caregiver Sable Smith, who was informed of the purpose of the visit.

During the visit, LPA learned Resident #1 (R1) never resided at this facility through records review and interviews.

Based on record reviews and interviews, the allegations listed above are Unfounded. A finding of Unfounded means the allegation could not have happened, is false, and/or is without a reasonable basis.

LPA conducted an exit interview and a copy of this report was provided to Caregiver Gloria Reyes.