Complaint Investigation Report

335530240-4-29-2026-56-AS-KCLS-DVF3PR-20260626182558

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

04/22/2026 and conducted by Evaluator Andrew Martinez

COMPLAINT CONTROL NUMBER: 56-AS-20260422110040

ANGEL'S HAVEN CARE ASSISTED LIVING ELSINORE LLC

Staff lock residents inside the facility.

Licensing Program Analyst (LPA) Andrew Martinez made an unannounced visit to the facility to

initiate a complaint investigation and deliver findings for the above allegation. LPA met with Caregiver, Gilbert Oteyza, and explained the purpose for today's visit. The investigation consisted of observations, record reviews, and interviews with pertinent parties.

Regarding the allegation - Staff lock residents inside the facility: During facility tour, LPA observed a child-proof door lever latch lock located on the inside of the entryway (front) door. LPA interviewed two (2) staff caregivers (S1, S2), both of whom stated the lever latch lock was installed to safeguard Resident 1 (R1) from eloping again as they like to open doors and have prior elopement history. LPA observed the front door is equipped with a signal system to notify staff when door has been opened.

Based on today's investigation, the above allegation is SUBSTANTIATED. A SUBSTANTIATED finding is defined as a violation has occurred based on the preponderance of available evidence. An exit interview was conducted where this report LIC9099, LIC9099D and Appeal Rights were discussed and a copy provided to Caregiver, Gilbert Oteyza.