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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 360910501
Report Date: 07/09/2025
Date Signed: 07/09/2025 01:13:53 PM

Substantiated


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
03/13/2025 and conducted by Evaluator Eldin Serrano
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20250313161650
FACILITY NAME:OPARC ADULT DEVELOPMENTAL CENTER-MONTE VISTAFACILITY NUMBER:
360910501
ADMINISTRATOR:HERNANDEZ, ANNABELLFACILITY TYPE:
775
ADDRESS:9160 MONTE VISTA AVE.TELEPHONE:
(909) 621-3884
CITY:MONTCLAIRSTATE: CAZIP CODE:
91763
CAPACITY:66CENSUS: 62DATE:
07/09/2025
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Ike Petra, Assistant Program DirectorTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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The Facility Staff Inappropiately Touch a Client.
INVESTIGATION FINDINGS:
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On July 9, 2025, at 12:15 PM, Licensing Program Analyst (LPA) Eldin Serrano visited the facility to investigate the allegation mentioned and deliver findings. LPA met with Assistant Program Manager (APM) Ike Petra to discuss the purpose of the visit.

The investigation consisted of reviewing facility files and interviewing relevant parties. The allegation indicates that The Facility Staff Inappropriately touched client #1. Based on interviews with relevant parties, it was stated that on 3/10/25 client #1 (C1) was heard screaming and making noises and waving their hand in the air to grab attention. It was reported that staff #1 (S1) saw staff #3 (S3) grab or touch C1’s left breast with their left hand. Based on record review it showed that S3 was put on administrative leave the following day (3/11/25) and terminated from work on 4/30/2025.

Based on file reviews and interviews, the preponderance of evidence standard has been met, therefore, the allegation is substantiated under the California Code of Regulations (Title 22, Division 6 & Chapter 3).

An exit interview was conducted, where this report,LIC9099, LIC9099D along with appeal rights, were provided to Assistant Program Manager Ike Petra.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Eldin Serrano
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2025
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-20250313161650
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: OPARC ADULT DEVELOPMENTAL CENTER-MONTE VISTA
FACILITY NUMBER: 360910501
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/09/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/09/2025
Section Cited
CCR
82072(a)(1)
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82072 Personal Rights
(a) Each client shall have personal rights which include, but are not limited to, the following:(1) To be accorded dignity in his/her personal relationships with staff and other persons.
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The licensee agreed to conduct an in-service all staff training on Personal Rights to all working staff and provide a staff roster with proof of training and staff signatures to LPA/CCL by POC date 07/16/2025.
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82072(a)(1) – Personal Rights ...This requirement is not met as evidenced by: Based on records review, interviews with relevant parties; the allegation that facility staff inappropriately touched a client is substantiated. This poses an immediate health risk to clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Eldin Serrano
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2025
LIC9099 (FAS) - (06/04)
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