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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336407366
Report Date: 04/09/2025
Date Signed: 04/09/2025 02:43:47 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
04/04/2025 and conducted by Evaluator Raquel Hernandez
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20250404094117
FACILITY NAME:BENSON HOUSE, INC. #6FACILITY NUMBER:
336407366
ADMINISTRATOR:ALFRED ORTIZFACILITY TYPE:
735
ADDRESS:4601 CALIFORNIA AVENUETELEPHONE:
(951) 279-8180
CITY:NORCOSTATE: CAZIP CODE:
92860
CAPACITY:5CENSUS: 5DATE:
04/09/2025
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Administrator Al OrtizTIME COMPLETED:
02:50 PM
ALLEGATION(S):
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Staff hit a client while in care
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 Administrator Al Ortiz and explained the purpose of the visit. The investigation consisted of staff and client interviews and request of documentation.

For the allegation, Staff hit a client while in care.

LPA Hernandez conducted (3) client interviews. 3 out of the 3 clients stated facility staff have not hit them while in care nor have witnessed facility staff hit other clients while in care. LPA Hernandez conducted (4) staff interviews. 4 out of the 4 staff stated they do not hit any of the clients in while nor have witnessed other facility staff hit clients while in care.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2025
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-20250404094117
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: BENSON HOUSE, INC. #6
FACILITY NUMBER: 336407366
VISIT DATE: 04/09/2025
NARRATIVE
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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 pertaining to these allegations 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 Al Ortiz.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2