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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336426511
Report Date: 11/13/2025
Date Signed: 11/13/2025 02:45:31 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
08/18/2022 and conducted by Evaluator Mary Rico
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20220818162839
FACILITY NAME:AVISTA SENIOR LIVING MAGNOLIAFACILITY NUMBER:
336426511
ADMINISTRATOR:MONIQUE DEL JUNCOFACILITY TYPE:
740
ADDRESS:737 MAGNOLIA AVETELEPHONE:
(951) 737-1600
CITY:CORONASTATE: CAZIP CODE:
92879
CAPACITY:0CENSUS: DATE:
11/13/2025
UNANNOUNCEDTIME BEGAN:
01:33 PM
MET WITH:TIME COMPLETED:
01:34 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident became emaciated while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/13/2025 Licensing Program Analyst (LPA) Mary Rico mailed a certificated letter to deliver the findings on the allegation listed above. The investigation consisted of staff interviews, resident interviews, and document review.

On August 18, 2022, the Department received a complaint with allegation of resident become emaicated while in care.The Department investigation consisted of review of facility and other records and interviews with pertinent individuals.

Based on residents’ interviews, staff interviews and record review. There was no evidence to collaborate with the allegation listed above. Based on information found and discovered, LPA found that 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 deemed UNSUBSTANTIATED.A copy of this report (LIC9099) was mailed to facility’s designated mailing address
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
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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