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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881631
Report Date: 04/23/2026
Date Signed: 04/23/2026 05:38:30 PM

Substantiated


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
04/15/2026 and conducted by Evaluator Yolanda Delgado
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20260415090212
FACILITY NAME:MEADOWBROOK PLACE ASSISTED LIVINGFACILITY NUMBER:
331881631
ADMINISTRATOR:SCOTT, ANDREAFACILITY TYPE:
740
ADDRESS:461 E JOHNSTON AVENUETELEPHONE:
(818) 470-6457
CITY:HEMETSTATE: CAZIP CODE:
92543
CAPACITY:49CENSUS: 20DATE:
04/23/2026
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Andrea Scott, AdministratorTIME COMPLETED:
05:45 PM
ALLEGATION(S):
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Staff did not ensure that hot water was made available at the facility for residents in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst, (LPA) Yolanda Delgado arrived unannounced at the facility to initiate an investigation pertaining to the allegation listed above. LPA met with Andrea Scott and explained the purpose of the visit.

On April 15, 2026, Community Care Licensing received a complaint alleging Staff did not ensure that hot water was made available at the facility for residents in care. It was alleged there was no hot water in the facility for over one week.

Interview with relevant party stated it was reported there was no hot water on April 6, 2026, and the facility was waiting on parts. Interviews conducted with residents and staff revealed there were issues with the hot water taking a long time to get hot, not working and having to use the next door Building #1 to shower and the hot water started working 4 days ago consistently without interruption.
(Continued on Page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Yolanda Delgado
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)
Page: 1 of 3
Control Number 18-AS-20260415090212
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: MEADOWBROOK PLACE ASSISTED LIVING
FACILITY NUMBER: 331881631
VISIT DATE: 04/23/2026
NARRATIVE
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(Continued from Page 1)

An interview with the Administrator Andrea Scott, revealed the facility has had issues with the hot water for over a week starting in the beginning of April and it was being worked on by their Maintenance person and parts had to be ordered, staff were boiling water to give residents sponge baths at bedside. LPA reviewed and obtained a copy of receipt #086969 dated 3/8/2026 to “Terry” for $120.00 to look at water heater. Attempts to interview maintenance person and Licensee were attempted but not successful. LPA tested water temperatures for Buildings #1 and #2 and hot water is working with caution signs posted. Administrator Andrea Scott had to leave before finalizing the report, gave permission for staff to sign the report.

Based on the interviews, the allegation is substantiated. The facility will be cited for Title 22, Division 6, Chapter 8, Article 05, Section 87303(a)(e)(2) and will be issued Civil Penalties of $500.

An exit interview was conducted with Angela Caban and a copy of this report, LIC809D, LIC421IM and Appeal Rights was provided.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Yolanda Delgado
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)
Page: 2 of 3
Control Number 18-AS-20260415090212
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: MEADOWBROOK PLACE ASSISTED LIVING
FACILITY NUMBER: 331881631
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/23/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/24/2026
Section Cited
HSC
87303(a)(e)(2)
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87303 Maintenance and Operation
(a) The facility shall be clean, safe, sanitary and in good repair at all times… maintenance services and procedures for the safety and well-being of residents, employees and visitors. (e) Water supplies and plumbing fixtures shall be maintained as
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Licensee will ensure the hot water is working at all times and is maintained for residents. A hot water plan will be created and submitted to LPA by POC due date. The deficiency was cleared the same day due to hot water was verified for the facility.
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follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). This requirement was not being met as evidenced by: LPA conducted interviews with Administrator, staff and residents it was revealed there was no hot water in Building #2 for over a week, staff was boiling water to give sponge baths at bedside, residents had to take showers in Building #1. This poses an immediate health and safety risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Yolanda Delgado
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2026
LIC9099 (FAS) - (06/04)
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