<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 330900784
Report Date: 05/05/2025
Date Signed: 05/05/2025 01:43:55 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/29/2025 and conducted by Evaluator Beena Singh
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20250429085933
FACILITY NAME:PEPPERMINT RIDGEFACILITY NUMBER:
330900784
ADMINISTRATOR:STEPHANIE BARRONFACILITY TYPE:
735
ADDRESS:825 MAGNOLIATELEPHONE:
(951) 273-7320
CITY:CORONASTATE: CAZIP CODE:
92879
CAPACITY:12CENSUS: 6DATE:
05/05/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Facility Administrator/operations Manager-Jessica PazTIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff had inappropriate interaction with resident.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst, (LPA) Beena Singh conducted an unannounced visit to the facility-Peppermint Ridge-Aspen House to initiate a complaint and deliver findings on a complaint alleging Client #1 (C1) Facility staff had inappropriate interaction with client.

LPA Singh met with Facility manager/Administrator-Jessica Paz and was granted entry into the facility. The investigation conducted by LPA Singh consisted of interviews and records review.

The investigation conducted by LPA Singh consisted of record reviews and interviews with facility staff, residents and relevant parties. Interviews indicated/revealed that four(4) out of four staff and four (4) out of six (6) clients denied any inappropriate interactions of staff with clients in care and that staff denied witnessing any inappropriate interactions by any staff with any clients in care.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 56-AS-20250429085933
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: PEPPERMINT RIDGE
FACILITY NUMBER: 330900784
VISIT DATE: 05/05/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on the investigation, LPA Singh was not able to find any evidence to corroborate the allegation. Interviews with Staff and clients at the facility indicated no inappropriate interaction between staff and clients ever happened at this facility. Staff and clients at the facility also stated that there is no staff with the name “James” employed at this facility.

Based on interview and record review in investigation, the allegation listed above is deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.

An exit interview was conducted where this report was discussed and provided to Facility Administrator/Operations manager Jessica Paz.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2