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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361880596
Report Date: 07/16/2025
Date Signed: 07/16/2026 10:34:49 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
07/10/2025 and conducted by Evaluator Lavette Farlow
COMPLAINT CONTROL NUMBER: 56-AS-20250710131820
FACILITY NAME:CAROLINE STREETFACILITY NUMBER:
361880596
ADMINISTRATOR:AMOS AKINTOYEFACILITY TYPE:
735
ADDRESS:14461 CAROLINE STTELEPHONE:
(442) 249-1310
CITY:ADELANTOSTATE: CAZIP CODE:
92301
CAPACITY:4CENSUS: DATE:
07/16/2025
UNANNOUNCEDTIME BEGAN:
02:03 PM
MET WITH:Amos Akintoye, Administrator TIME COMPLETED:
04:10 PM
ALLEGATION(S):
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9
Facility is neglecting residents in care.
INVESTIGATION FINDINGS:
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On 7/16/2026, Licensing Program Analyst (LPA) LaVette Farlow conducted an unannounced visit to facility to gather signatures on an Amended report. LPA met with Administrator, Aveon Popoola.

Licensing Program Analyst (LPA) LaVette Farlow arrived at the facility unannounced to investigate a complaint for the allegation listed above. LPA met with Licensee, Amos Akintoye. The investigation consisted of observations, interviews with staff and clients and records review.

It is alleged that the facility is neglecting residents in care. Interviews with clients 1 and 2 (C1) and (C2) stated that staff one (S1) did not help (C1) wipe herself while in the shower. Interviews with 3 out of 3 staff revealed that staff assist residents as needed and most of the time the residents do not need assists with shower or incontinence needs and are very self-sufficient. Staff stated C1 showers without assistance, but occasionally has issues with diarrhea. LPA interviewed 3 out of 3 residents in care and 3 out of 3 resident stated staff are very helpful and assist with their needs if needed. 3 out of 3 residents stated they are independent.
***Continued LIC9099C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2025
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-20250710131820
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: CAROLINE STREET
FACILITY NUMBER: 361880596
VISIT DATE: 07/16/2025
NARRATIVE
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LPA Farlow reviewed the video footage in the facility on the date of this incident and LPA Farlow observed staff assisting the resident in care and cleaning the facility. Based on the video footage, interviews, and observation, the allegation is unsubstantiated.

Based on the evidence, the allegation are UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means that although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. No deficiencies were cited during this visit. An exit interview was conducted where this report was discussed and provided to Aveon Popoola, Administrator.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2