Complaint Investigation Report

361800195-12-12-2025-56-AS-NBRN-DTFV2J-20260424160309

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

10/10/2025 and conducted by Evaluator Renese Howell-Small

COMPLAINT CONTROL NUMBER: 56-AS-20251010154830

Staff pushed client and dragged on the carpet

On 12/12/2025 at 11:15AM Licensing Program Analyst (LPA) Renese Howell-Small conducted an unannounced visit to the facility in order to deliver findings for the above allegation. LPA discussed the purpose of the visit with staff, Angela Eyitayo. The investigation consisted of interviews and record review.

In regards to the allegation of staff pushed client and dragged on the carpet:

LPA interviewed staff, Client 1 (C1) and a relative of C1. Staff denied the allegation and stated C1's behavior includes false statements. When questioned by staff, C1's explanations were inconsistent. The relative of C1 stated that they did not observe any injuries and C1 would have informed them if staff caused an injury. Based upon interviews and record review, this allegation is UNSUBSTANTIATED.

UNSUBSTANTIATED is defined as the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted where this report LIC9099 was discussed and a copy was provided to staff, Angela Eyitayo.