Iris Family Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Robert Campbell conducted an unannounced annual required visit. Upon entry, LPA were greeted by Blanca Kincherlow/Licensee, and informed them of the purpose of the visit. At the time of the visit, there was one (1) staff member and three (3) residents present. LPA later met with Jacqueline Kincherlow/Administrator. Facility Overview: The facility is a one-story home with four (4) bedrooms and three (3) bathrooms, including an attached garage. There are no pools or known firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility has infection control plan in file. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. The outdoor area was free of hazards. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked and inaccessible to residents. Both the smoke detector and carbon monoxide detector were operational, and the hot water temperature was 114°F. Fire extinguisher located by the Administrator's desk and has an current inspection tag. (5/2026) Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Continued on LIC809-C.... Continued.... Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate. Record Review and Resident/Staff Files: LPA reviewed files for three (3) staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Three (3) resident files were reviewed and contained all the required documents. Health-Related Services/Incidental Medical Services: All resident medications were securely locked in kitchen island cabinet. LPA reviewed medications for three (3) residents, confirming that all medications were listed on the Medication Administration Record (MAR) and accounted for. Personal & Incidental Funds: All Resident monies are not handled by the facility. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last emergency drill conducted on 03-13-2026, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed and provided.the state’s words, verbatim · CDSS document, Jun 23, 2026

Allegation investigated: Staff do not provide activities for resident

On March 04, 2026, Licensing Program Analyst (LPA), Venus Mixson arrived unannounced at the facility and met with the Administrator, Jacqueline Kincherlow. LPA explained the reason for the visit was to provide findings for the complaint investigation. During the investigation, LPA conducted interviews, record reviews, and made observations pertaining to the listed allegation. On July 30, 2025, Community Care Licensing received a complaint alleging staff do not provide activities for residents. Information obtained from an interview with Licensee revealed the allegation was false. Licensee indicated the facility has scheduled activities and provided LPA with a copy of an activities calendar. Information obtained through interviews with additional staff revealed residents are able to engage or refuse to participate in activities. It was stated activities included music therapy, reading, exercise classes, and games. It was also stated the facility offers structured and individualized activities as well. It was stated that activities are tailored to residents’ abilities and interests. Information received from interviews with three of three residents indicated facility staff provides activities for all residents in care. Additionally, resident interviews indicated activities are decided and suggested by the residents. Information received from interviews with Additional Witnesses, which are residents’ responsible parties, stated facility staff do provide activities for residents and there are no concerns. Information obtained from interview with Witness, Hospice Nurse assigned to one of the residents, indicated they have been present while residents were participating in activities. During the inspection, on February 17, 2026, LPA observed two of three residents participating in a trivia game and exercise class. LPA’s observations confirmed information documented on the facilities activities schedule. LPA observed the activities calendar to be posted at the facility on several unannounced visits, 08/06/2025, and again on 02/17/2026. Based on information obtained from interviews, record reviews, and observations, the evidence received pertaining to the allegation that staff do not provide activities for residents was deemed unfounded. An unfounded finding indicates that the allegation is false, could not have happened, or is without a reasonable basis. This allegation has been dismissed. An exit interview was conducted. A copy of this report was discussed and given to the Administrator, Jacqueline Kincherlow. Unfoundedthe state’s words, verbatim · CDSS document, Mar 4, 2026 · control 18-AS-20250730134050

Allegation investigated: Staff are using cameras in residents rooms. Staff leave residents in bed during the day.

On March 04, 2026, Licensing Program Analyst (LPA), Venus Mixson arrived unannounced at the facility and met with the Administrator, Jacqueline Kincherlow. LPA explained the reason for the visit was to provide findings for the complaint investigation. During the investigation, LPA conducted interviews, record reviews, and made observations pertaining to the listed allegations. On July 30, 2025, Community Care Licensing received a complaint alleging staff are using cameras in residents’ room with video/sound, and staff leave residents in bed during the day. Regarding the Allegation:Staff are using cameras in residents rooms; it was reported there were cameras in each of the three resident’s bedrooms with video and sound capability. Information obtained from an interview with the Licensee revealed they denied the allegation. Licensee indicated that the device is not being used by the facility as a camera, but as a motion detector. Licensee indicated that the device was being used to assist with acknowledging and reviewing falls and providing attention in a timely manner. Licensee also advised that the monitor does not have a SIM card, therefore; the device is unable to record. Licensee stated residents and their authorized parties were made aware at the time of admission that a device is placed in resident’s bedrooms. Information obtained from an interview with staff revealed the device does have video and audio capability with the utilization of the SIM card. Information obtained from interviews with three of three residents revealed during the admission process, they were advised there were devices in the resident’s bedrooms that assist with monitoring movement and motion. Three of three residents were not advised the devices had video and audio capability. Information obtained from interviews with Additional Witnesses, that were residents’ responsible parties, confirmed they were aware of the devices in the bedrooms but were not informed the devices had video and audio capability. Unsubstantiated LPA's review of the records, including three of three of the residents “Acknowledgment & Consent Forms,” signed and dated by residents and their responsible parties, revealed that they (Acknowledge and Consent to the use of the facilities fall and prevention of a non-recording baby monitor in each of the resident’s rooms. The information obtained from the review of documentation revealed that residents and their authorized representatives were advised of a monitoring device in each of the resident’s room. Regarding the allegation, Staff leave residents in bed during the day; it was reported that residents were observed to be in bed at approximately 1:00pm. It was further reported residents are required to eat meals in their bed. Licensee denied the allegation. Licensee stated facility staff do not leave residents in bed during the day and residents do not have to eat their meals in their bed. Licensee stated residents can be in bed if the residents choose. Licensee stated residents eat their meals in the designated dining area, unless the resident chooses not to. Information obtained from an interview with an additional staff member indicated they do not leave residents in bed during the day and residents are transferred out of bed daily for meals and other activities. Information obtained from interviews with three of three residents, indicated the facility staff do attend to their daily needs and assist with transferring out of bed. None of the residents expressed any concerns with staff leaving them in bed during the day or being forced to eat in their rooms. Information obtained from additional witnesses, the residents Responsible Parties revealed that they saw their family member up and out of bed while visiting. Information obtained from an interview with Hospice Nurse indicated that they were at the facility twice a week and observed staff getting residents out of bed for meals and activities. Based on information obtained from interviews, record reviews, and observations, the evidence received pertaining to the allegation that staff are using cameras in residents’ rooms with video and audio capability, and staff leave residents in bed during the day, did not meet the preponderance of the evidence standard and therefore, has been deemed unsubstantiated. An unsubstantiated allegation means that the preponderance of the evidence standard has not been met. An exit interview was conducted, and a copy of this report was discussed and given to the Administrator,Jacqueline Kincherlow.the state’s words, verbatim · CDSS document, Mar 4, 2026 · control 18-AS-20250730134050

Type of visit: Case Management - Other

On December 17, 2025, Licensing Program Analyst (LPA), Venus Mixson arrived to the facility to conduct a Case Management visit and met with the Licensee, Jacqueline Kincherlow. LPA made observations and conduct interviews pertaining to another matter, along with a review of the records. Physical Plant: The location is a single-story home located at 1712 Bridle Trail San Jacinto, CA. 92582, and has four bedrooms, three full bathrooms, a living room, dining room, and a kitchen, with a two-car garage. A backyard and front yard. The Riverside Fire Department approved this facility for zero (0) Ambulatory, five (5) Non-Ambulatory, and one (1) bedridden residents, on December 20, 2024. The home has a first aid kit and manual, the Administrator has received First Aid and CPR training. Medications: Were stored, locked, and inaccessible to the residents. The home is equipped with lights in the passages and stocked with emergency night lights. The smoke and carbon monoxide detectors were observed and are operable. The fire extinguisher is charged and in the green. Cleaning supplies were locked and inaccessible, along with the sharp objects. Bedrooms: Were large enough to allow for easy passage between the beds, and other required items of furniture were present. There was sufficient lighting for residents. Rooms were large enough to support the increase to five non ambulatory. Kitchen/Food: The knives were locked in a kitchen drawer, plenty of pots, pans, and other kitchen accessories. The facility has the required seven-day supply of non-perishable food items and the two-day supply of perishable food items. LPA Mixson observed hygiene supplies for residents. There were no pesticides, poisons, or other toxic substances stored near any food storage or preparation area. There were no observable Health and/or Safety violations observed or cited on todays visit. An exit interview was conducted and a copy of this report was provide to the Licensee, Interviews record reviewsthe state’s words, verbatim · CDSS document, Dec 17, 2025

Type of visit: Case Management - Other

On January 16, 2025, Licensing Program Analyst (LPA), Venus Mixson arrived to the facility to conduct a case management visit in order to make observations pertaining to the changes from ambulatory to non ambulatory and bedridden. Physical Plant: The location is a single-story home located at 1712 Bridle Trail San Jacinto, CA. 92582, and has four bedrooms, three full bathrooms, a living room, dining room, and a kitchen, with a two-car garage. A backyard and front yard. The Riverside Fire Department approved this facility for zero (0) Ambulatory, five (5) Non-Ambulatory, and one (1) bedridden residents, on December 20, 2024. The home has a first aid kit and manual, the Administrator has received First Aid and CPR training. Medications: Were stored, locked, and inaccessible to the residents. The home is equipped with lights in the passages and stocked with emergency night lights. The smoke and carbon monoxide detectors were observed and are operable. The fire extinguisher is charged and in the green. Cleaning supplies were locked and inaccessible, along with the sharp objects. Bedrooms: Were large enough to allow for easy passage between the beds, and other required items of furniture were present. There was sufficient lighting for residents. Rooms were large enough to support the increase to five non ambulatory. Kitchen/Food: The knives were locked in a kitchen drawer, plenty of pots, pans, and other kitchen accessories. The facility has the required seven-day supply of non-perishable food items and the two-day supply of perishable food items. LPA Mixson observed hygiene supplies for residents. There were no pesticides, poisons, or other toxic substances stored near any food storage or preparation area. Records: There is confidential storage space for personnel records. Bathrooms: The bathrooms floors were clean and sanitary and free of odors, water and other appliances were operable, water temperature tested within regulations. There was at least one toilet and sink for each six persons to include residents and at least one bathtub/shower for each ten persons which includes residents, family and/or live-in personnel. Administration: Emergency exiting plans and telephone numbers posted, Personal Rights, Complaint Poster, and other required documents were posted. The current Administrators certification is posted with an expiration date of 04/19/2025. The facility theft and loss program policy are posted. Activities: There are activity supplies and equipment available for residents. Including access to daily newspapers, current magazines, and a variety of reading materials in the language of choice. Miscellaneous: There is a first aid kit, including sterile dressings, bandages, thermometer, and other items as required by regulations. There are laundry supplies and equipment, including machine in good repair, and there is space for clean linen storage and a separate space for soiled linen. LPA Mixson observed emergency lighting supplies to include flashlights, and extra batteries, along with vehicles used to transport residents. There were no observable regulation violations. An exit interview was conducted and a copy of this report was provided to the Administrator, Jacqueline Kincherlow.the state’s words, verbatim · CDSS document, Jan 16, 2025

Type of visit: Prelicensing

On June 07, 2024, Licensing Program Analyst (LPA), Venus Mixson arrived for a scheduled visit for the purpose of conducting a Pre-Licensing visit. LPA Mixson met with the Administrator, Jacqueline Kincherlow introduced herself, and stated the purpose of the visit. Physical Plant: The location is a single-story home located at 1712 Bridle Trail San Jacinto, CA. 92582, and has four bedrooms, three full bathrooms, a living room, dining room, and a kitchen, with a two-car garage. A backyard and front yard. The Riverside Fire Department approved this facility for two (2) Ambulatory, three (3) Non-Ambulatory, and one (1) bedridden residents, on March 19, 2024. The home has a first aid kit and manual, the Administrator has received First Aid and CPR training, and the Administrator’s certificate is current, and will expire April 19, 2025. Medications: LPA Mixson observed where medications are to be stored, locked, and inaccessible to the residents. The home is equipped with lights in the passages and stocked with emergency night lights throughout the home. The smoke and carbon monoxide detectors were observed and are operable. LPA Mixson observed the fire extinguisher, it was charged and in the green, and serviced on 02/05/2023. The cleaning supplies were locked and inaccessible, along with the sharp objects and the Administrator informed the LPA there are no firearms on the premises. Bedrooms: The bedrooms were large enough to allow for easy passage between the beds, and other required items of furniture were present currently at the time of this inspection. Chair, nightstand, and sufficient lighting for future residents. Kitchen/Food: The knives were locked in a kitchen drawer, plenty of pots, pans, and other kitchen accessories. The facility has the required seven-day supply of non-perishable food items and the two-day supply of perishable food items. LPA Mixson observed hygiene supplies for residents. There were no pesticides, poisons, or other toxic substances stored near any food storage or preparation area currently at the time of this inspection. (87555). Records: There is confidential storage space for personnel records currently. (87412). Bathrooms: The bathrooms floors were clean and sanitary and free of odors, water and other appliances were operable, water temperature tested within regulations. There was at least one toilet and sink for each six persons to include residents, family, and personnel. (87307), and at least one bathtub/shower for each ten persons which includes residents, family and/or live-in personnel. (87307). Administration: LPA Mixson observed emergency exiting plans and telephone numbers posted, Personal Rights, Complaint Poster, and other required documents were posted currently at the time of this visit, along with the current Administrators certification. The facility theft and loss program policy are posted, currently at the time of this inspection. (87218). Activities: There are activity supplies and equipment available for future residents. Including access to daily newspapers, current magazines, and a variety of reading materials in the language of choice. There is an outdoor activity area equipped for outdoor use. (87219). Miscellaneous: There is a first aid kit, including sterile dressings, bandages, thermometer, and other items as required by regulations. (87465). There are laundry supplies and equipment, including machine in good repair, and there is space for clean linen storage and a separate space for soiled linen. (87307). LPA Mixson observed emergency lighting supplies to include flashlights, and extra batteries, along with vehicles used to transport residents are operable and registered as stated by the Administrator. (87303). Dementia Care: There were no bodies of water on the premises currently at the time of this visit, and there are auditory devices in place to monitor exits and completely enclosed outdoor activity space with self-closing latches and gates. (87705). Inside/Outside: All doors, and passageways are clear of obstruction. There were no bodies of water, or fireplaces on the premises. There was enough clean linen and hygiene items, and there was appropriate lighting in each room. LPA Mixson observed central air conditioning, and heating systems, and they are operable. The Administrator dialed the land line facility phone number (951) 665-6092, and it was operable. Outside/Yard: outside space was available to provide shade and covering for shaded visits, and activities. There were no obstructions or debris observed. The Licensee stated there were no firearms, and/or ammunition on the premises. CAB 8.0 Pre-licensing / COMP III Requested and is scheduled. An exit interview was conducted, a copy of this report was provided to the Administrator, Jacqueline Kincherlow.the state’s words, verbatim · CDSS document, Jun 7, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Interview Method: Telephone interview On 5/29/2024, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, May 29, 2024