Complaint Investigation Report

360900455-7-1-2026-56-AS-NBRN-DW8VMM-20260722163345

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

06/23/2026 and conducted by Evaluator Sarina Ramirez

COMPLAINT CONTROL NUMBER: 56-AS-20260623172640

Resident sustained fractures and other injuries due to staff neglect or physical abuse

Licensee does not ensure there are adequate staff to meet resident's needs

Staff did not address a resident's change in medical condition in a timely manner

Staff did not ensure residents toileting needs were met

Licensing Program Analyst (LPA) Sarina Ramirez conducted an unannounced visit to the facility to conduct a complaint investigation on the above allegations. LPA met with Administrator Jessica Ramos, and discussed the purpose of the visit.

Regarding allegations above, The Administrator informed LPA that resident #1 (R1) never resided in the assisted living facility but resided in the skilled nursing facility. LPA obtained a resident roster from the skilled nursing facility that verifies R1 lived at the skilled nursing facility. Based on LPA's interviews and record review, the above allegations are Unfounded.

An Unfounded finding means, the allegation is false, could not have happened, and/or is without a reasonable basis.

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