Complaint Investigation Report

361880801-2-12-2026-56-AS-KCLS-DRH2UF-20260220164216

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

02/14/2025 and conducted by Evaluator Eldin Serrano

COMPLAINT CONTROL NUMBER: 56-AS-20250214135233

Facility staff did not provide resident's authorized representative with resident's records.

On 2/12/2026, Licensing Program Analysts (LPA) Eldin Serrano visited the facility to investigate the above-mentioned allegation and deliver findings. LPA met with the administrator Michael Garcia to discuss the purpose of the visit. The investigation consisted of interviewing relevant parties and record reviews.

The allegation indicates that the facility staff did not provide resident's authorized representative with resident's records. – Based on interviews with relevant parties and file review, the facility did not provide the documents requested upon the resident's written consent or that of her designated representative within the time allowed by the regulation..

Based on interviews and file review, the preponderance of evidence standard has been met, therefore, the allegation is substantiated under the California Code of Regulations (Title 22, Division 6 & Chapter 8).

An exit interview was conducted, where this report, LIC9099, LIC9099D along with appeal rights, were provided to the administrator Michael Garcia.