Complaint Investigation Report

361880724-8-18-2025-56-AS-NBRN-DLTTLC-20250924144919

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

08/12/2025 and conducted by Evaluator Eldin Serrano

COMPLAINT CONTROL NUMBER: 56-AS-20250812104335

Staff did not properly maintain facility sinks

On August 18, 2025, Licensing Program Analyst (LPA) Eldin Serrano visited the facility to investigate the mentioned allegation and deliver findings. LPA met with Caregiver Rosalinda Pinella to discuss the purpose of the visit.

The investigation consisted of observation and interview of staff. The allegation indicates that Staff did not properly maintain facility sinks. LPA observed that the faucets on the facility kitchen sink and resident bathroom sink are both leaking water. Interview with staff revealed that both faucets were leaking for a while and the landlord fixed it but now the faucet is back to leaking again. Citation will be issued.

Based on observation and interview, the preponderance of evidence standard has been met, therefore, the allegation is substantiated under the California Code of Regulations (Title 22, Division 6 & Chapter 1).

An exit interview was conducted, where this report, LIC9099, and LIC9099D along with appeal rights, were provided to the Caregiver Rosalinda Pinella.