361880507-1-13-2026-56-AS-EMAN-DQHNCG-20260120092043

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361880507
Report Date: 01/13/2026
Date Signed: 01/13/2026 01:59:08 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
07/18/2025 and conducted by Evaluator Beena Singh

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20250718112941

FACILITY NAME:	YELLOW IRIS RESIDENTIAL CARE		FACILITY NUMBER:	361880507
ADMINISTRATOR:	OSBY, TAMMY		FACILITY TYPE:	735
ADDRESS:	7666 YELLOW IRIS COURT		TELEPHONE:	(909) 346-0392
CITY:	FONTANA	STATE: CA	ZIP CODE:	92336
CAPACITY:	4	CENSUS: 4	DATE:	01/13/2026
		UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Facility Licensee/Administrator-Tammy Osby		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff handled resident in a rough manner resulting in injury.

INVESTIGATION FINDINGS:

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On 1/13/2026, Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to the facility to deliver findings on a complaint alleging Staff handled resident in a rough manner resulting in injury. LPA Singh met with Facility Licensee-Tammy and Conrad Osby, and was granted entry into the facility. The investigation conducted by Department Staff consisted of interviews and records review.

The investigation was initiated after a Reporting Party (RP) and conservator alleged that Staff#1 (S1) shoved Client #1 (C1)s face into the carpet during a behavioral episode, causing a dental bridge to break. The alleged incident occurred shortly after C1 had returned to the facility following dental work.

Seven (7) out of Seven (7) facility staff members interviewed stated they did not witness S1 use any physical force on C1. They noted that C1 has a significant history of self-harm, including headbutting himself, biting his own wrists and arms to the point of requiring medical attention. They also reported that C1 had previously pulled out his own tooth.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2026

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-20250718112941

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: YELLOW IRIS RESIDENTIAL CARE	FACILITY NUMBER: 361880507
	VISIT DATE: 01/13/2026

NARRATIVE

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Four (4) out of four (4) Clients at the facility denied seeing any physical force used by S1. They provided positive character references for S1, stating they missed S1s presence at the facility. When interviewed, C1 was unable to explain how the injury occurred but spoke fondly of S1 and stated C1 missed S1 at the facility.

The dentist who performed dental work on C1 indicated that the bridge was durable and in order for the bridge to break C1 would have needed to bite down on something extremely hard and twisted it in their mouth. The dentist added that C1’s tooth could have broken if it was hit straight on with something hard. Crucially, the dentist noted that there was no evidence of any facial trauma on C1, which typically accompanies a forceful impact on the face.

The department Staff concluded that there was insufficient evidence to prove the allegation of abuse occurred. The combination of C1s documented history of aggressive self-harm, the lack of corroborating witness testimony, and the absence of external facial injuries led department staff to determine that the injury could not be definitively linked to staff misconduct.

Based on the evidence found during the investigation, the allegations listed Staff handled resident in a rough manner resulting in injury, is deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were 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 Facility Licensee Tammy Osby and Conrad Osby.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2026

LIC9099 (FAS) - (06/04)

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