360908345-3-3-2026-56-AS-EMAN-DU8VWL-20260519164806

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360908345
Report Date: 03/03/2026
Date Signed: 03/03/2026 10:14:15 AM

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
02/27/2026 and conducted by Evaluator Raquel Hernandez

COMPLAINT CONTROL NUMBER: 56-AS-20260227083359

FACILITY NAME:	BENSON HOUSE		FACILITY NUMBER:	360908345
ADMINISTRATOR:	SHAWN COLETTA		FACILITY TYPE:	735
ADDRESS:	1941 S. BENSON		TELEPHONE:	(909) 983-7884
CITY:	ONTARIO	STATE: CA	ZIP CODE:	91762
CAPACITY:	9	CENSUS: 4	DATE:	03/03/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Administrator Shawn Coletta		TIME COMPLETED:	10:20 AM

ALLEGATION(S):

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Licensee does not ensure administrator has an active administrator certification

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Raquel Hernandez conducted an unannounced visit for the purpose of delievering findings for the above allegation. LPA met with Administrator Shawn Colleta and explained today's visit.

On 02/27/2026, the department received a complaint regarding that Administrator Shawn Coletta does not have an active administrator's certification. Per record review, Administrator Colleta submitted application and fees on 01/10/2026. However, CAB (Centralized Application Bureau) attempted to reach out regarding application and it appears wrong contact address was provided. Administrator contacted CAB to resolve any issues. As of today 03/03/2026, Administator has submitted application and is waiting for CAB to reach back with any questions or concerns.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2026

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-20260227083359

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	FACILITY NUMBER: 360908345
	VISIT DATE: 03/03/2026

NARRATIVE

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Based on the evidence gathered during today’s investigation, the allegation listed above is 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 the allegations was 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 Shawn Coletta.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2026

LIC9099 (FAS) - (06/04)

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