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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880731
Report Date: 03/09/2026
Date Signed: 03/09/2026 01:42:30 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
02/11/2026 and conducted by Evaluator Beena Singh
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20260211092211
FACILITY NAME:MCT HOMEFACILITY NUMBER:
331880731
ADMINISTRATOR:STIEN BAWENGANFACILITY TYPE:
735
ADDRESS:31376 TULETTE LNTELEPHONE:
(714) 414-2246
CITY:WINCHESTERSTATE: CAZIP CODE:
92596
CAPACITY:4CENSUS: 4DATE:
03/09/2026
UNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Facility Administrator Stein BawenganTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Neglect/Lack of supervision resulted in client sustaining injuries.
INVESTIGATION FINDINGS:
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On 03/9/2026, Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to the facility to deliver findings on a complaint alleging neglect/lack of supervision. LPA Singh met with facility administrator Stein Bawengan and was granted entry into the facility. Facility has census of Four(4) and three(3) clients were out in the community and one(1) client#1 was at the facility. The investigation conducted by LPA Singh consisted of interviews and records reviews.

Review of the facility records indicate Client#1 (C1), who was a resident at the MCT facility, had a fall during a shower and facility staff took immediate action to apply for first-aid, cold compress and called the administrator who after assessing the head skin graze and scratch on C#1 left eye transported C#1 to Emergency Room(ER), where C#1 had further evaluation and had CT Scan-head and face, x-ray on his pelvic, eye check were performed at the ER and results came back normal.

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

DATE: 03/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2026
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-20260211092211
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: MCT HOME
FACILITY NUMBER: 331880731
VISIT DATE: 03/09/2026
NARRATIVE
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Client#1 has a dedicated 1:1 aide, these injuries were reported to Community Care Licensing Division (CCLD), and professional medical treatment was provided to Client#1. Furthermore, there was a communication between AM Staff with 1:1 aide/Staff who provided detailed explanation to Client#1s aide/Staff who acknowledge receiving detailed report from the morning staff, noting that morning staff verbally reported such incidents to the afternoon shift and been documented in shift notes. According to record reviews by LPA Singh, all the falls and incidents have been reported to CCLD. Four(4) out of Four(4) stated Staff at the facility always looks after the clients in care and communicates with morning or afternoon shift staff regarding clients in care.


In conclusion, based on all the information obtained during the investigation, it is
determined that, when Resident#1 fall facility staff immediately acted and provided C#1 medical treatment and evaluation and reported to CCLD. Due to a lack of information, the above allegations are deemed UNSUBSTANTIATED at this time.

Unsubstantiated; meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.


An exit interview was conducted where reports (LIC9099, LIC9099-C were discussed and provided to Facility Administrator Stein Bawengan at the conclusion of the visit.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2