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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880604
Report Date: 12/05/2024
Date Signed: 12/05/2024 02:03:24 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
10/25/2024 and conducted by Evaluator Raquel Hernandez
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20241025110240
FACILITY NAME:CREST VILLAFACILITY NUMBER:
331880604
ADMINISTRATOR:RAMASAR, OSCARFACILITY TYPE:
740
ADDRESS:4014 CALIFORNIA AVETELEPHONE:
(951) 268-6040
CITY:NORCOSTATE: CAZIP CODE:
92860
CAPACITY:15CENSUS: 14DATE:
12/05/2024
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Administrator Oscar & Ghislaine RamasarTIME COMPLETED:
02:10 PM
ALLEGATION(S):
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Staff handled resident in a rough manner.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Raquel Hernandez conducted an unannounced visit to deliver findings on the allegation listed above. LPA met with Administrators Oscar & Ghislaine Ramasar and explained the purpose of the visit. The investigation consisted of staff and resident interviews and request of documentation.

For the allegation, Staff handled resident in a rough manner.

LPA Hernandez conducted (4) staff interviews. During the staff interviews (4) out of the (4) staff stated they have not handled any resident in care in a rough manner or witnessed any resident being handled in a rough manner by staff at facility.

LPA Hernandez conducted (7) resident interviews. During resident interviews (5) out of the (7) residents stated staff at facility have not handled them in a rough manner. (5) out of the (7) residents stated all staff treat them with respect and help them whenever they need assistance.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
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-20241025110240
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: CREST VILLA
FACILITY NUMBER: 331880604
VISIT DATE: 12/05/2024
NARRATIVE
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(2) out of the (7) residents in care stated they have witnessed staff treat other residents in a rough manner. (2) out of the (7) residents stated staff have not treated them in a rough manner.

Based on the evidence gathered during today’s investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC9099) was discussed and provided to Administrator Oscar and Ghislaine Ramasar.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2