Complaint Investigation Report

366425610-5-21-2026-56-AS-KCLS-DUJ5KQ-20260528200155

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

02/10/2026 and conducted by Evaluator Sarina Ramirez

COMPLAINT CONTROL NUMBER: 56-AS-20260210101558

Resident was not accorded dignity in their relationship with a person in the home

Licensing Program Analyst (LPA) Sarina Ramirez conducted an unannounced visit to the facility to deliver findings on a complaint investigation regarding the above allegation. LPA met with Administrator Dorris Anderson and discussed the purpose of the visit.

Regarding the allegation that a resident was not accorded dignity in their relationship with a person in the home, interviews with the Administrator and resident revealed that the individual in question was a minor family member. In accordance with regulations, minors are not required to undergo fingerprinting or background clearance. The individual was not residing in the home during the investigation, and interviews indicate that during the period in which they did reside at the home, they were not disruptive to residents.

Based on LPAs observations and interviews, the above allegation is Unsubstantiated; meaning that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted where this report was discussed and a copy was provided Administrator Dorris Anderson at the conclusion of the visit.