335530048-3-12-2025-56-AS-EMAN-DFUMGY-20250418093643

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 335530048
Report Date: 03/12/2025
Date Signed: 03/12/2025 10:16:24 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
03/11/2025 and conducted by Evaluator Mary Rico

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20250311093049

FACILITY NAME:	EMMA'S CASE ARF INC.		FACILITY NUMBER:	335530048
ADMINISTRATOR:	CHAVEZ, ALIX GARCIA		FACILITY TYPE:	735
ADDRESS:	20043 CASE ST		TELEPHONE:	(909) 316-9555
CITY:	CORONA	STATE: CA	ZIP CODE:	92881
CAPACITY:	4	CENSUS: 3	DATE:	03/12/2025
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Administrator- Alix Garcia		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Staff hit resident while in care.
Staff handled resident in a rough manner.
Staff yelled at resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to investigate and deliver findings on the allegations listed above. LPA met with Administrator Alix Garcia and explained the purpose of the visit. The investigation consisted of (2) staff interviews, (2) client interviews and record review.

For the allegation, Staff hit resident while in care.

During staff interviews, 2 out of the 2 staff stated they did not hit residents in while care. During client interviews 2 out of the 2 clients stated they have not been hit by staff.

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

During staff interviews, 2 out of the 2 staff stated they have not handled a resident in a rough manner.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 56-AS-20250311093049

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: EMMA'S CASE ARF INC.	FACILITY NUMBER: 335530048
	VISIT DATE: 03/12/2025

NARRATIVE

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For the allegation, Staff yelled at client.

During staff interviews, 2 out of the 2 staff stated they do not yell at clients. During clients’ interviews, 2 out of the 2 client’s stated staff do not yell at them. Furthermore, C1 admitted to making false allegations against the facility.

Based on the evidence found during the investigation, the three (3) allegations listed above are 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, and this report (LIC9099) was discussed and provided to Administrator Alix Garcia.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

LIC9099 (FAS) - (06/04)

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