335530163-2-9-2026-56-AS-KCLS-DR82NN-20260211163301

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 335530163
Report Date: 02/09/2026
Date Signed: 02/09/2026 01:38:00 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
08/15/2025 and conducted by Evaluator Eldin Serrano

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20250815094718

FACILITY NAME:	COMFORT SENIOR VILLA		FACILITY NUMBER:	335530163
ADMINISTRATOR:	AGUINALDO, KRISTEN		FACILITY TYPE:	740
ADDRESS:	3133 SONRISA DRIVE		TELEPHONE:	(951) 246-2273
CITY:	CORONA	STATE: CA	ZIP CODE:	92881
CAPACITY:	6	CENSUS: 4	DATE:	02/09/2026
		UNANNOUNCED	TIME BEGAN:	12:20 PM
MET WITH:	Mya Aguinaldo Staff		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Personal Rights
Neglect lack of supervision
Staff limit residents the use of tolietry supplies.
Staff do not provide resident with adequate food service.
Staff do not ensure facility cleanliness is maintained.

INVESTIGATION FINDINGS:

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On 2/9/2026 at 12:20 PM, Licensing Program Analyst (LPA) Eldin Serrano made an unannounced visit to the facility to investigate and deliver the findings of the above allegations. LPA Serrano met Staff Mya Aguinaldo to explain the purpose of the visit. The investigation consisted of file review, interviews with facility staff and residents as well as facility observation.

Allegation #1: Personal Rights – Based on information received during staff and resident’s interviews, all of them stated that the staff never violated any of the residents’ personal rights. LPA was unable to corroborate the allegation.

Allegation #2: Neglect lack of Supervision - Based on interview with residents and staff, all of them stated that the staff never neglected the residents’ request for medical care. If the resident needs immediate medical attention, they will call the medical emergency. If it is not an emergency, they will call their primary doctor. LPA was unable to corroborate the allegation.

*** Continuation in LIC9099C ***

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Eldin Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2026

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-20250815094718

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: COMFORT SENIOR VILLA	FACILITY NUMBER: 335530163
	VISIT DATE: 02/09/2026

NARRATIVE

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Allegation #3: Staff limits residents the use of toiletry supplies - Based on interviews and information received during the investigation both staff interviewed stated that the facility never limits the use of toiletry for the residents. LPA observed sufficient supply of toiletries in the resident’s bathroom. LPA was unable to corroborate the allegation.

Allegation #4: Staff do not provide resident with adequate food service – Based on observation the facility has adequate amount of perishable and non-perishable food at the facility. LPA was unable to corroborate the allegation.

Allegation #5 – Staff do not ensure facility cleanliness is maintained – Based on LPA observation the facility staff-maintained cleanliness and free of obstructions. LPA observed no activity of pests or insects’ infestation at the facility during the visit. LPA was unable to corroborate the allegation.

Information received during investigation LPA did not find evidence to corroborate the allegations.

Based on the evidence, the allegations mentioned above are UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means 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, therefore the allegation is unsubstantiated at this time.

An exit interview was conducted where this report, LIC9099 and LIC9099C were discussed and provided to staff Mya Aguinaldo.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Eldin Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2026

LIC9099 (FAS) - (06/04)

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