Complaint Investigation Report

366426710-5-13-2025-56-AS-KCLS-DGWSGQ-20250522135219

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

05/06/2025 and conducted by Evaluator Sarina Ramirez

COMPLAINT CONTROL NUMBER: 56-AS-20250506142250

Licensing Program Analyst (LPA) Sarina Ramirez made an unannounced visit to the facility to conduct a complaint investigation on the above complaint allegation. LPA met with Executive Director Eileen Sanchez, and discussed the purpose of the visit.

Regarding the allegation, Facility is in disrepair, it was alleged the facility's second floor carpet was lifting and causing a fall hazard. LPA observed the second floor carpet and it is lifting throughout the entire hallway. The Executive Director stated that a maintenance person will be at the facility on 5/19/25 to replace the carpet with hard flooring.

Based on observation and interviews, the allegation is Substantiated. Substantiated meaning that the allegation is valid because the preponderance of the evidence standard has been met.

An exit interview was conducted where reports (LIC9099&LIC9099-D) were discussed and provided with appeal rights to Executive Director Eileen Sanchez at the conclusion of the visit.