361800458-4-10-2025-56-AS-NBRN-DHLUPW-20250613154614

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361800458
Report Date: 04/10/2025
Date Signed: 04/10/2025 12:39:29 PM

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
02/22/2025 and conducted by Evaluator Renese Howell-Small

COMPLAINT CONTROL NUMBER: 56-AS-20250222183144

FACILITY NAME:	ADVANTAGE CARE FACILITY		FACILITY NUMBER:	361800458
ADMINISTRATOR:	TORRES, MELVIN		FACILITY TYPE:	740
ADDRESS:	27438 STRATFORD STREET		TELEPHONE:	(909) 910-5629
CITY:	HIGHLAND	STATE: CA	ZIP CODE:	92346
CAPACITY:	6	CENSUS: 4	DATE:	04/10/2025
		UNANNOUNCED	TIME BEGAN:	09:09 AM
MET WITH:	Administrator, Melvin Torres		TIME COMPLETED:	12:35 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not inform the resident's authorized person of the resident's death
Licensee did not refund the resident's authorized person following the resident's death
Resident was overcharged by the licensee for services
Staff did not safeguard the resident's personal items

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 04/10/2025 at 9:09AM Licensing Program Analyst (LPA) Renese Howell-Small conducted an unannounced visit to the facility in order to deliver findings for the above allegations. LPA discussed the purpose of the visit with Administrator, Melvin Torres. The investigation consisted of interviews and record review.
In regards to the allegation of staff did not inform the resident's authorized person of resident's death:
LPA interviewed the Administrator, a representative from a placement agency, reviewed R1's Admission Agreement and reviewed the Sheriff's Department report dated 01/15/2025. LPA confirmed that R1 was capable of making independent decisions, was self-responsible and did not list any relatives or friends on the facility's documents. Therefore, this allegation is UNSUBSTANTIATED.

In regards to the allegation of licensee did not refund the resident's authorized person following the resident's death: LPA interviewed the Administrator and reviewed R1's Admission Agreement. R1 did not list any relatives or friends on the facility's documents, therefore there was not an authorized person to contact. According to the Admission Agreement, R1's personal belongings were kept for at least fifteen (15) days and no refund was required. Therefore, this allegation is UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2025

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-20250222183144

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: ADVANTAGE CARE FACILITY	FACILITY NUMBER: 361800458
	VISIT DATE: 04/10/2025

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

In regards to the allegation of resident was overcharged by the licensee for services: LPA interviewed the Administrator, reviewed R1's Admission Agreement and medical documentation. R1 did not list any relatives or friends on the facility's documents. R1's level of care increased and R1 was notified that due to the change in level of care, per the Admission Agreement, the cost of care would increase. In addition, R1 began to receive hospice care services on 06/20/2023. Therefore, this allegation is UNSUBSTANTIATED.

In regards to the allegation of staff did not safeguard the resident's personal items: LPA interviewed three (3) staff and four (4) residents. All four (4) of the residents denied that their personal items are not safeguarded. All three (3) staff denied that the facility did not safeguard the resident's personal items. Staff state that the residents are given privacy and have a place to store personal items. R1's personal items were kept for at least fifteen (15) days before some of the items were discarded. On 01/02/2025, upon request R1's relative was given the remainder of R1's personal items.

Based upon record review and interviews the above allegations are UNSUBSTANTIATED. UNSUBSTANTIATED is defined as the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted where this report LIC9099 and LIC9099C was discussed and a copy was provided to Administrator, Melvin Torres.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 2