331880902-8-25-2026-18-AS-JDHS-DXGVAA-20260831161533

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880902
Report Date: 07/21/2026
Date Signed: 08/25/2026 10:11:54 AM

Unsubstantiated

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
03/12/2026 and conducted by Evaluator Ahliah Sharp

COMPLAINT CONTROL NUMBER: 18-AS-20260312145021

FACILITY NAME:	BUENA VISTA ASSISTED LIVING		FACILITY NUMBER:	331880902
ADMINISTRATOR:	ICAMEN, ROBYN		FACILITY TYPE:	740
ADDRESS:	1393 S. BUENA VISTA ST.		TELEPHONE:	(951) 658-5160
CITY:	HEMET	STATE: CA	ZIP CODE:	92543
CAPACITY:	74	CENSUS: 48	DATE:	07/21/2026
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Robyn Icamen, Executive Director		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Staff do not serve residents with food of good quality
Staff did not meet resident’s showering needs.
Staff do not safeguard resident's personal belongings

INVESTIGATION FINDINGS:

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LPA contacted Reporting Party (RP) and they stated the Alleged Victim (AV) no longer wishes to follow through with the complaint.

On July 21, 2026, Licensing Program Analyst (LPA), Ahliah Sharp, conducted an unannounced visit to the facility to deliver the findings regarding the allegations above. During the investigation, LPA conducted an inspection of the facility, interviewed Staff and Residents, reviewed facility records and meal logs from the weeks of January 19th-25th; January 26th-February 1st; February 23rd -29th and March 2nd -8th.

On March 12, 2026, Community Care Licensing (CCL) received a complaint alleging that Staff do not safeguard Resident's personal belongings, Staff do not serve Residents with food of good quality, and Staff did not meet Resident’s showering needs.

Continued on LIC9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Jacob Garber
LICENSING EVALUATOR NAME: Ahliah Sharp
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2026

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-20260312145021

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: BUENA VISTA ASSISTED LIVING	FACILITY NUMBER: 331880902
	VISIT DATE: 07/21/2026

NARRATIVE

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Continued from LIC9099...

Regarding the allegation pertaining to the quality of food, information obtained from interviews with Residents indicated there are no concerns regarding the quality of the food. LPA observed menus which identified a typical breakfast consisting of Oatmeal, cereal, and milk that are offered daily in addition to itemized scheduled breakfast items (e.g., omelets, toast, pancakes, fruit, yogurt etc.). Lunch menu provides flexible options (sandwiches nachos, soup, etc.) and an afternoon snack at 2:30pm. Dinner also has a flexible schedule with pork chops, meat loaf, ravioli and salads etc., and an evening snack at 7:00pm.

Regarding the allegation pertaining to Staff not meeting Resident’s showering needs, information obtained from an interview with Executive Director (ED) Robyn Icamen, the facility abides by and maintains a shower schedule for Residents. It was explained there is an application on their work phone that provides them with the schedule of who is supposed to shower that day and if a Resident opts out, it is logged in this system. Information obtained from interviews with Staff confirmed the information. Information obtained from interviews with Residents had no complaints about their showering needs being met. It was further reported that some Residents refuse showers, but the facility works with Residents to prevent this from being problematic or habitual. Residents were able to articulate which day(s) of the week they were scheduled and reported never missing their designated day. LPA observed the shower schedule log; it indicated that Residents receive their regularly scheduled showers.

Regarding the Resident’s belongings being safeguarded, information from ED indicated that this has not been an issue or area of concern. Apart from occasional laundry mishaps; which is typically rectified quite quickly, due to Staff’s familiarity with Resident’s belongings, this has not been an issue that she has been made aware of. Information obtained from interviews with Staff stated the same thing as what was shared above; an occasional mishap with laundry. Information obtained from interviews with Residents, two Residents mentioned issues with their belongings. It was stated that laundry is often misplaced but typically provided later. The remaining Residents interviewed reported no issues with their belongings.

Continued on LIC9099C...

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Ahliah Sharp
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2026

LIC9099 (FAS) - (06/04)

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Control Number 18-AS-20260312145021

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: BUENA VISTA ASSISTED LIVING	FACILITY NUMBER: 331880902
	VISIT DATE: 07/21/2026

NARRATIVE

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Continue from LIC9099C...

Based on information obtained from interviews with Staff and Residents, record review, and observation, the allegation that Staff do not safeguard Resident's personal belongings, Staff do not serve Residents with food of good quality, and Staff did not meet Resident’s showering needs, have all been deemed UNSUBSTANTIATED. Unsubstantiated means although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are Unsubstantiated.

An exit interview was conducted and a copy of this report was provided to ED Robyn Icamen

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Ahliah Sharp
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2026

LIC9099 (FAS) - (06/04)

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