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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 330910238
Report Date: 12/19/2025
Date Signed: 12/19/2025 11:27:49 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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
09/16/2025 and conducted by Evaluator Paola Guerrero
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20250916091712
FACILITY NAME:PEPPERMINT RIDGE - ASPENFACILITY NUMBER:
330910238
ADMINISTRATOR:PAZ,JESSICAFACILITY TYPE:
735
ADDRESS:860 ASPEN STREETTELEPHONE:
(951) 273-7343
CITY:CORONASTATE: CAZIP CODE:
92879
CAPACITY:6CENSUS: 6DATE:
12/19/2025
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Terray Doty- Facilty ManagerTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff is verbally abusing residents.
Staff are not providing adequate supervision to residents.
Staff are mismanaging resident's medications.
Staff does not ensure resident's do not have access to sharp objects.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Paola Guerrero arrived at the facility to deliver investigative findings. LPA met with Facility Manager Terray Doty and explained the purpose of the visit regarding the allegations listed above.

First allegation: Staff is verbally abusing residents. Regarding the allegation stated above LPA conducted interviews with C#1-3 LPA went over the allegation stated above with the clients and all three clients denied being verbally abused by staff. In addition, C#1-3 also denied witnessing staff verbally abuse clients in care. LPA conducted an interview with S#1 regarding the allegation stated above and S#1 denied the allegation. In addition, S#1 denied witnessing staff verbally abuse clients in care.

Second allegation: Staff are not providing adequate supervision to residents. Regarding the allegation stated above LPA conducted an interview with C#1-3 LPA went over the alleged allegation with the clients and all three clients informed LPA that facility provides supervision daily furthermore, C#1-3 informed LPA that staff are always available when needed.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2025
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-20250916091712
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: PEPPERMINT RIDGE - ASPEN
FACILITY NUMBER: 330910238
VISIT DATE: 12/19/2025
NARRATIVE
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 In addition, C#1-3 informed LPA that they feel safe at their home. LPA conducted an interview with S#1 regarding the alleged allegation S#1 informed LPA that staff are always ensuring that the proper supervision is always being provided and given to the clients. S#1 denied the allegation pertaining to staff not providing adequate supervision to clients in care.

Third allegation: Staff are mismanaging resident's medications. Regarding the allegation stated above, LPA conducted a walkthrough of the facility and observed medications to be locked and secure. LPA conducted interviews with C#1-3 LPA went over the alleged allegation with the clients and C#1-3 informed LPA that medications remain locked and only dispensed by staff. Furthermore, C#1-3 denied the allegation regarding staff mismanaging medication. LPA conducted an interview with S#1 LPA went over the alleged allegation with S#1 and S#1 informed LPA that clients do not have access to medications and medications always remain locked and secure.

Fourth allegation: Staff does not ensure resident's do not have access to sharp objects. Regarding the allegation stated above, LPA conducted a walkthrough of the facility during the walkthrough LPA did not find or observe any sharp objects or knives to be out or accessible to clients in care. LPA conducted an interview with C#1-3 LPA went over the alleged allegation with the clients and all three clients informed LPA that all sharps remain locked and secure. LPA conducted an interview with S#1 LPA went over the alleged allegation with S#1 and S#1 informed LPA that clients do not utilize scissors and stated that all sharps remain locked and secure. In addition, S#1 denied the allegation pertaining to clients having access to sharp objects. During the review or resident’s shower schedule LPA observed residents to receive shower twice-three times a day. Based on corroborating evidence the department has determined that the above allegations are Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided t

Facility Manager Terray Doty.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2