<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336409176
Report Date: 09/19/2025
Date Signed: 09/19/2025 02:51:55 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
04/15/2024 and conducted by Evaluator Magda Malcore
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240415154253
FACILITY NAME:LAKES, THEFACILITY NUMBER:
336409176
ADMINISTRATOR:LORI MATSUSHITAFACILITY TYPE:
740
ADDRESS:5801 SUN LAKES BLVDTELEPHONE:
(951) 845-2220
CITY:BANNINGSTATE: CAZIP CODE:
92220
CAPACITY:0CENSUS: 132DATE:
09/19/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Cristina Ceballos - Executive DirectorTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not mitigate the spread of a contagious disease.
Staff did not ensure resident's toileting needs were met.
Staff did not safeguard residents' personal possessions.
Licensee did not adhere to resident's Admission Agreement.
Staff did not ensure resident's bathroom was maintained in sanitary conditions.
Staff did not provide resident(s) with adequate food service.
Staff did not address resident's choking risk.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced complaint visit to the facility. LPA met with Executive Director, Cristina Ceballos, and informed the purpose of the visit.

Regarding allegation #1, staff did not mitigate the spread of a contagious disease, interviews with five (5) staff and six (6) residents reveal staff do mitigate the spread of contagious diseases. LPA observed a sufficient amount of cleaning and sanitizing products, soaps, masks, and gloves stored at the facility. In addition, staff interviews reveal they have been trained in infection control.

Regarding allegation #2, staff did not ensure resident's toileting needs were met, interviews with five (5) staff and six (6) residents reveal that staff do ensure resident’s toileting needs were met. In addition, LPA observed a sufficient amount of toileting supplies stored at the facility.

**continued on LIC9099-C**
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2025
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-20240415154253
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: LAKES, THE
FACILITY NUMBER: 336409176
VISIT DATE: 09/19/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Regarding allegation #3, staff did not safeguard residents' personal possessions, interviews with five (5) staff denied that they did not safeguard resident’s personal possessions. Interviews with five (5) out of six (6) residents deny that staff did not safeguard their personal possessions.
Regarding allegation #4, Licensee did not adhere to resident's Admission Agreement, it was alleged that Licensee was not adhering to resident’s admission agreement by allowing other residents to use their private bathroom. Interviews with five (5) staff and six (6) residents reveal that the Licensee did adhere to resident’s Admission Agreement.

Regarding allegation #5, staff did not ensure resident’s bathroom was maintained in sanitary conditions, LPA observed six (6) resident’s bathrooms were maintained clean and sanitary. Interviews with five (5) staff and six (6) residents reveal that staff ensure residents’ bathrooms are maintained in sanitary conditions.

Regarding allegation #6, staff did not provide resident(s) with adequate food service, LPA observed in the kitchen a list of residents with special diets. Interviews with five (5) staff and six (6) residents reveal that staff do provide resident(s) with adequate food service.

Regarding allegation #7, staff did not address resident's choking risk, interviews with five (5) staff and six (6) residents reveals not enough evidence to corroborate that staff did not address resident’s choking risk.

Based on LPA observations, interviews with staff and residents, the allegations mentioned in this report are Unsubstantiated. 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 this report was discussed. The report copy was provided with appeal rights to Executive Director Ceballos at the conclusion of the visit.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2