Complaint Investigation Report
336426511-11-13-2025-56-AS-EMAN-DNHMVR-20251117085709
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
SAN BERNARDINO , 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
08/18/2022 and conducted by Evaluator Mary Rico
COMPLAINT CONTROL NUMBER: 56-AS-20220818162839
On 11/13/2025 Licensing Program Analyst (LPA) Mary Rico mailed a certificated letter to deliver the findings on the allegation listed above. The investigation consisted of staff interviews, resident interviews, and document review.
On August 18, 2022, the Department received a complaint with allegation of resident become emaicated while in care.The Department investigation consisted of review of facility and other records and interviews with pertinent individuals.
Based on residents’ interviews, staff interviews and record review. There was no evidence to collaborate with the allegation listed above. Based on information found and discovered, LPA found that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed UNSUBSTANTIATED.A copy of this report (LIC9099) was mailed to facility’s designated mailing address
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction