Complaint Investigation Report

331881569-12-5-2025-18-AS-APEZ-DPAVF6-20251212152326

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

12/02/2025 and conducted by Evaluator Abdoulaye Zerbo

COMPLAINT CONTROL NUMBER: 18-AS-20251202115457

Staff did not provide resident adequate care and supervision to prevent the resident from wandering away from the facility

Licensing Program Analyst (LPA), Abdoulaye Zerbo conducted an unannounced visit to the facility to investigate the allegation listed above. LPA met with Caregiver Michael Hernandez, who was informed of the purpose of the visit. Administrator Bashar Mayyas joined the visit at a later time.

LPA toured the facility and obtained copies of pertinent records. During the visit, LPA learned Resident #1 (R1) never resided at this facility through records review and interviews. The Administrator also confirmed that R1 never resided at this facility.

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 Administrator Bashar Mayyas.