Complaint Investigation Report

360900455-1-23-2026-56-AS-KCLS-DSZNDY-20260410102308

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

01/21/2026 and conducted by Evaluator Sarina Ramirez

COMPLAINT CONTROL NUMBER: 56-AS-20260121131011

Staff did not provide a safe environment for a resident in care.

Licensing Program Analysts (LPAs) Sarina Ramirez and Eldin Serrano conducted an unannounced visit to the facility to initiate a complaint investigation. LPAs met with Administrator Jessica Ramos, and explained the purpose of the visit.

It is alleged staff are not providing a safe environment for a resident in care. Based on interviews with staff and residents, it was determined that Resident 1 (R1) was pushed by Resident 2 and 3 (R2 & R3) on accident. R1, R2, and R3 all are in wheelchairs, R2 can only maneuver in reverse, R2 did not realize R1 was in the same path. R3 is non verbal, Based on interviews it is noted R1 is mostly upset because R2 and R3 did not apologize.

Based on LPA's observations and interviews, the above allegation is unsubstantiated. This means that although the allegation 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 where this report was discussed, and a copy was provided to Administrator Jessica Ramos at the conclusion of the visit.