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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800087
Report Date: 08/19/2026
Date Signed: 08/19/2026 10:55:34 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO 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
06/15/2026 and conducted by Evaluator Eldin Serrano
COMPLAINT CONTROL NUMBER: 56-AS-20260615082319
FACILITY NAME:MERCY HOME 3FACILITY NUMBER:
331800087
ADMINISTRATOR:AJUNWA, MERCILLINAFACILITY TYPE:
740
ADDRESS:36427 PISTACHIO DRIVETELEPHONE:
(951) 599-0565
CITY:WINCHESTERSTATE: CAZIP CODE:
92596
CAPACITY:6CENSUS: 6DATE:
08/19/2026
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Mercillina Ajunwa, AdministratorTIME COMPLETED:
11:10 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not ensure resident is allowed to have visitors at the facility.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 8/19/2026 Licensing Program Analyst (LPA) Eldin Serrano made an unannounced visit to the facility to commence the complaint investigation and deliver the findings of the above allegation. LPA explained the purpose of the visit to Administrator Mercillina Ajunwa. The investigation consisted of record reviews, interviews with the reporting party and staff as well as observation.

Allegation: Staff does not ensure resident is allowed to have visitors at the facility. LPA did not find evidence showing facility staff restricted or prevented visitation. Interviews confirm visitation challenges were due to family disagreements and not facility action. Staff allowed RP to visit R1 during the investigation without issue.

Based on interviews, observations, and record review, the allegations mentioned above is UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means although the allegation may have happened or may be valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is unsubstantiated at this time.
An exit interview was conducted where this report LIC9099 was discussed and provided to Administrator Mercillina Ajunwa.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Eldin Serrano
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2026
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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