335530062-7-10-2026-56-AS-EMAN-DW9MZK-20260723100315

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 335530062
Report Date: 07/10/2026
Date Signed: 07/10/2026 04:13:46 PM

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
03/08/2026 and conducted by Evaluator Mary Rico

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20260308204555

FACILITY NAME:	TWIN HEARTS SENIOR CARE II		FACILITY NUMBER:	335530062
ADMINISTRATOR:	MANGENTE, KRISTINE		FACILITY TYPE:	740
ADDRESS:	342 E OLIVE STREET		TELEPHONE:	(951) 373-9122
CITY:	CORONA	STATE: CA	ZIP CODE:	92879
CAPACITY:	6	CENSUS: 5	DATE:	07/10/2026
		UNANNOUNCED	TIME BEGAN:	02:45 PM
MET WITH:	Staff- Melati Wulansari		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff failed to properly care for the resident’s pressure injuries, resulting in worsening conditions.

INVESTIGATION FINDINGS:

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On 7/10/2026, Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to deliver findings on the allegation listed above. LPA met with staff Melati Wulansari and explained the purpose of the visit. The investigation consisted of staff interviews, hospice interviews and record reviews. The Licensee Kristine A. Mangente was contacted and informed about today’s visit.

For the allegation,Staff failed to properly care for the resident’s pressure injuries, resulting in worsening conditions. During staff interviews, 2 out of 2 staff stated that proper care was provided to R1. It was revealed that R1 was on hospice and was receiving treatment for pressure injuries. In addition, the Registered Nurse confirmed they visited R1 and provided treatment for the pressure injuries and also confirmed that the injuries were not worsening. Nurse also confirmed that the pressure injuires were stage one and early-stages. Evidence shows that R1 was receiving treatment for pressure sores from Hospice.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2026

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-20260308204555

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: TWIN HEARTS SENIOR CARE II	FACILITY NUMBER: 335530062
	VISIT DATE: 07/10/2026

NARRATIVE

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Based on the evidence obtained during the investigation, the allegation listed above is deemed UNSUBSTANTIATED. A finding of UNSUBSTANTIATED means that although the allegation may have happened or may be valid, there is not a preponderance of evidence to prove that the alleged violation 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 with and provided to staff Melati Wulansari.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2026

LIC9099 (FAS) - (06/04)

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