361880724-5-21-2026-56-AS-KCLS-DWEN9Y-20260728101643

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361880724
Report Date: 05/21/2026
Date Signed: 05/21/2026 12:22:38 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
03/19/2026 and conducted by Evaluator Sarina Ramirez

COMPLAINT CONTROL NUMBER: 56-AS-20260319083310

FACILITY NAME:	ATIENZA RESIDENTIAL CARE		FACILITY NUMBER:	361880724
ADMINISTRATOR:	ARMSTRONG, CAROLINE		FACILITY TYPE:	740
ADDRESS:	911 HARTZELL AVE		TELEPHONE:	(909) 792-3835
CITY:	REDLANDS	STATE: CA	ZIP CODE:	92374
CAPACITY:	6	CENSUS: 4	DATE:	05/21/2026
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Caregiver Rose Penilla		TIME COMPLETED:	12:35 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not answer residents calls for assistance timely
Staff did not intervene when resident hit another resident

INVESTIGATION FINDINGS:

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

Licensing Program Analyst (LPA) Sarina Ramirez conducted an unannounced visit to the facility to deliver findings on a complaint investigation regarding the above allegations. LPA met with Caregiver Rose Penilla and discussed the purpose of the visit.

Regarding Allegation #1, that staff did not answer residents’ calls for assistance in a timely manner, LPA was unable to interview Staff #1 (S1) as they are no longer employed at the facility. However, interviews with current staff and the Administrator indicate that staff respond to residents’ calls for assistance in a timely manner.

Regarding Allegation #2, that staff did not intervene when one resident struck another, interviews with staff and outside parties revealed that Staff #1 (S1) was also struck by Resident #2 (R2) while attempting to intervene in the altercation between R1 and R2. Additional staff interviews confirmed that when an altercation is observed, it is staff’s duty to intervene

Based on LPAs observations, record review, and interviews, the above allegations are Unsubstantiated; meaning that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted where this report was discussed and a copy was provided to Caregiver Rose Penilla at the conclusion of the visit.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Sarina Ramirez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026

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 3

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
03/19/2026 and conducted by Evaluator Sarina Ramirez

COMPLAINT CONTROL NUMBER: 56-AS-20260319083310

FACILITY NAME:	ATIENZA RESIDENTIAL CARE		FACILITY NUMBER:	361880724
ADMINISTRATOR:	ARMSTRONG, CAROLINE		FACILITY TYPE:	740
ADDRESS:	911 HARTZELL AVE		TELEPHONE:	(909) 792-3835
CITY:	REDLANDS	STATE:CA	ZIP CODE:	92374
CAPACITY:	6	CENSUS: 4	DATE:	05/21/2026
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Caregiver Rose Penilla		TIME COMPLETED:	12:35 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not seek timely medical care for resident

INVESTIGATION FINDINGS:

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

Licensing Program Analyst (LPA) Sarina Ramirez conducted an unannounced visit to the facility to deliver findings on a complaint investigation regarding the above allegations. LPA met with Caregiver Rose Penilla and discussed the purpose of the visit.

Regarding the allegation that staff did not seek timely medical care for the resident, interviews with Resident #1’s (R1) responsible party revealed that R1 was struck in the back by another resident using a walker. Staff did not obtain medical evaluation for R1 following the incident despite complaints of back pain. An interview with the Administrator indicated that the staff on duty, who witnessed the altercation, did not follow instructions to call 911 when directed to do so

Therefore, based on the interviews conducted during the investigation, the above allegation is Substantiated. A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

An exit interview was conducted where this report LIC 9099, LIC 9099D and Appeal Rights were discussed, and a copy was provided to Caregiver Rose Penilla at the conclusion of the visit.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Sarina Ramirez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 56-AS-20260319083310

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: ATIENZA RESIDENTIAL CARE	FACILITY NUMBER: 361880724
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/21/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 05/22/2026 Section Cited CCR 87465(a)(2)	1 2 3 4 5 6 7	87465 Incidental Medical and Dental Care (a)A plan for incidental medical and dental care shall be developed by each facility...(2)The licensee shall provide assistance in meeting necessary medical and dental needs. This includes transportation... to the nearest available medical...facility which will meet the resident's need...The facility did not meet this requirement	1 2 3 4 5 6 7	Administrator will conduct training to all staff reviewing the regulation and provide proof of training and understanding with signatures to LPA by POC due date
	8 9 10 11 12 13 14	Licensee/Administrator did not comply with the regulation above by not providing medical care to R1 after being struck in the back by another resident, which poses an immediate health, safety, or personal rights risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Karen Clemons
LICENSING EVALUATOR NAME: Sarina Ramirez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026

LIC9099 (FAS) - (06/04)

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