Complaint Investigation Report

361881048-4-29-2026-56-AS-KCLS-DTMRPL-20260430131208

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

09/17/2025 and conducted by Evaluator Eldin Serrano

COMPLAINT CONTROL NUMBER: 56-AS-20250917164528

Resident sustained 1st and 2nd degree burns due to lack of supervision

On 04/29/2026 at 9:15 AM, Licensing Program Analyst (LPA), Eldin Serrano, visited the facility to deliver the investigative findings for the above allegation. LPA Serrano identified himself and discussed the purpose of the visit with Executive Director Monique Del Junco.

Allegation: – Resident sustained 1st and 2nd degree burns due to lack of supervision

It was alleged that resident #1 (R1) sustained first and second-degree burns due to lack of supervision by facility staff. The Department investigation consisted of review of facility records, hospital records, and police reports, as well as interviews with outside parties. The Department was unable to interview R1. Medical records reviewed during the investigation indicated no signs or symptoms of abuse. The hospital discharge diagnosis identified the resident’s condition as a first-degree sunburn to the bilateral lower extremities with cellulitis, along with leg pain and swelling.

Based on the information obtained, there is insufficient evidence to support that the resident’s condition was the result of neglect or lack of supervision by facility staff. Although the allegation may have occurred or may be valid, there is not a preponderance of evidence to establish that a violation occurred. Therefore, the allegation is unsubstantiated.

An exit interview was conducted where this report LIC9099 was discussed and provided to executive director Monique Del Junco.