361800147-2-9-2026-56-AS-KCLS-DRMW3M-20260225155610

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361800147
Report Date: 02/09/2026
Date Signed: 02/09/2026 10:55:14 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
01/30/2026 and conducted by Evaluator Eldin Serrano

COMPLAINT CONTROL NUMBER: 56-AS-20260130111357

FACILITY NAME:	MONTCLAIR ROYALE SENIOR LIVING		FACILITY NUMBER:	361800147
ADMINISTRATOR:	SANTOS, ANNAMARIE		FACILITY TYPE:	740
ADDRESS:	9685 MONTE VISTA AVE		TELEPHONE:	(909) 621-3545
CITY:	MONTCLAIR	STATE: CA	ZIP CODE:	91763
CAPACITY:	236	CENSUS: 122	DATE:	02/09/2026
		UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:			TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Staff are mismanaging residents' medications.
Staff are not ensuring residents' needs are being met due to inadequate staffing.
Staff are engaging in inappropriate behavior in the presence of residents

INVESTIGATION FINDINGS:

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On 2/09/2026 at 10:40 AM, Licensing Program Analyst (LPA) Eldin Serrano made an unannounced visit to the facility to investigate and deliver the findings of the above allegations. LPA Serrano met with care coordinator Araceli Soto to explain the purpose of the visit. The investigation consisted of file review, interviews with facility staff and residents as well as facility observation.

Allegation #1: Staff are mismanaging residents' medications. – Interviews with staff and residents confirmed that medications are administered as prescribed. The facility will implement a new system to discontinue the use of serving cups and has contracted with a pharmacy to provide multi-pack medications that are clearly labeled with dates, names, and times to improve efficiency and reduce errors. The LPA observed the medication cart to be securely locked. LPA was unable to corroborate the allegation.

*** Continuation in LIC9099C ***

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Eldin Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2026

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-20260130111357

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: MONTCLAIR ROYALE SENIOR LIVING	FACILITY NUMBER: 361800147
	VISIT DATE: 02/09/2026

NARRATIVE

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Allegation #2: Staff are not ensuring residents' needs are being met due to inadequate staffing. – Interviews with staff and residents confirmed that staff provide regular diaper changes and scheduled showers. It was confirmed that when the residents pressed their call light button, the staff promptly answered and responded to their needs. No evidence of staffing shortages was observed; therefore, the allegation could not be substantiated.

Allegation #3: Staff are engaging in inappropriate behavior in the presence of residents. – Interviews with staff and residents confirmed that no staff member was observed or witnessed engaging in inappropriate behavior or romantic relationship toward another staff member in the presence of residents. LPA was unable to corroborate the allegation.

Information received during investigation LPA did not find evidence to corroborate the allegations.

Based on the evidence, the allegations mentioned above are UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means 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 unsubstantiated at this time.

An exit interview was conducted where this report, LIC9099 and LIC9099C were discussed and provided to Care Coordinator Araceli Soto.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Eldin Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2026

LIC9099 (FAS) - (06/04)

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