Complaint Investigation Report

365530236-7-16-2026-56-AS-NBRN-DW2V8D-20260716161235

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

04/23/2026 and conducted by Evaluator Sarina Ramirez

COMPLAINT CONTROL NUMBER: 56-AS-20260423082736

Staff did not provide resident's authorized representative with invoices

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

LPA’s investigation revealed that R1 was removed from The Hills of Stillman on 03/06/26 and admitted to the hospital due to a heart attack, where R1 passed on 03/22/26. Residents authroized representative have requested invoices from facility staff with no response.

Based on the evidence and interviews gathered during the investigation, the above allegation is Substantiated. A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

An exit interview was conducted where this report LIC 9099 and LIC 9099D and Appeal Rights were discussed, and a copy was provided to Administrator .