Inspection Reports for Memory Care Our Countryside Resort
18111 Haines St, Perris, CA 92570, United States, CA, 92570
Back to Facility ProfileInspection Report Summary
Most inspections before licensure found no deficiencies, showing the facility was well prepared and compliant. The most recent report from October 23, 2025, identified two deficiencies: water temperature exceeding the allowed maximum and discrepancies in medication administration records. These issues were isolated and not severe, with no fines or enforcement actions noted in the available reports. There is a slight decline in compliance compared to the earlier clean reports, but the facility was generally well maintained with adequate infection control and supervision. No complaints were reported or investigated during this period.
Deficiencies per Year
4
3
2
1
0
Moderate
Census Over Time
Census
Capacity
Inspection Report
Annual Inspection
Census: 31
Capacity: 36
Deficiencies: 2
Oct 23, 2025
Visit Reason
An unannounced required annual inspection was conducted to evaluate compliance with licensing requirements at the facility.
Findings
The facility was generally well maintained with adequate infection control and supervision. However, deficiencies were cited related to water temperature exceeding the allowed maximum and discrepancies in medication administration for residents.
Severity Breakdown
Type B: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Water temperature measured at 130.0 degrees Fahrenheit in three locations, exceeding the maximum allowed temperature of 120 degrees Fahrenheit. | Type B |
| Discrepancies found in medication administration records for 3 of 3 residents reviewed, with missing medications. | Type B |
Report Facts
Water temperature: 130
Residents with medication discrepancies: 3
Capacity: 36
Census: 31
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Mahan | Administrator | Met with Licensing Program Analyst during inspection and named in report |
| Abdoulaye Zerbo | Licensing Program Analyst | Conducted the inspection and authored the report |
| Anthony Perez | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Original Licensing
Census: 16
Capacity: 36
Deficiencies: 0
Oct 15, 2024
Visit Reason
An announced pre-licensing evaluation visit was conducted to assess the facility's readiness for licensure.
Findings
The facility was found to be in compliance with no observed issues or concerns. Resident bedrooms and bathrooms were adequately furnished and equipped, safety equipment was tested and up to date, and food and medication storage met requirements.
Report Facts
Hot water temperature: 111.05
Hot water temperature: 108.9
Fire extinguisher service date: Aug 19, 2024
Fire inspection date: Oct 2, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Mahan | Administrator | Administrator whose certificate expires on 2/28/2026 and was involved in the facility tour and evaluation |
| Robert Ramos | Applicant | Applicant met with Licensing Program Analysts during the pre-licensing evaluation |
| Janette Romero | Licensing Program Analyst | Conducted the announced visit and evaluation |
| Debbie Palacios | Licensing Program Analyst | Conducted the announced visit and evaluation |
Inspection Report
Original Licensing
Census: 17
Capacity: 36
Deficiencies: 0
Oct 8, 2024
Visit Reason
Initial licensing evaluation conducted via virtual interview to verify applicant/administrator's understanding of community care facility licensing laws and readiness for facility operation.
Findings
The applicant and administrator demonstrated understanding of licensing laws, facility operation, admission policies, staffing, emergency preparedness, complaints reporting, and pre-licensing readiness during the COMP II virtual interview.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Mahan | Administrator | Participant in COMP II interview and applicant/administrator verified for licensing evaluation. |
| Lucia Ramos | Board Member | Participant in COMP II interview. |
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