Complaint Investigation Report

331881251-6-19-2025-56-AS-KCLS-DJUS89-20250723133846

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SAN BERNARDINO ASC , 1650 SPRUCE ST STE 200 MS29-27

This is an official report of an unannounced visit/investigation of a complaint received in our office on

06/12/2025 and conducted by Evaluator Sarina Ramirez

COMPLAINT CONTROL NUMBER: 56-AS-20250612161612

Resident was physically assaulted by another resident in care.

Licensing Program Analyst (LPA) Sarina Ramirez conducted an unannounced visit to the facility to conduct a complaint investigation on the above allegations. LPA met with Administrator Thelma Montebon and discussed the purpose of the visit.

Regarding allegation #1, Administrator informed LPA no residents have been in an altercation. LPA interviewed six (6) residents, all whom denied being in a physical altercation with other residents.

Regarding allegation #2, staff deny yelling at residents. LPA interviewed six (6) residents all whom deny being yelled at by staff.

Based on observation, interviews, and pertinent documents the allegations are unsubstantiated. An Unsubstantiated complaint means, that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted with Administrator Thelma Montebon and a copy of this report was provided at the conclusion of the visit.