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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361880801
Report Date: 01/09/2026
Date Signed: 01/09/2026 03:10:54 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
06/19/2024 and conducted by Evaluator Renese Howell-Small
COMPLAINT CONTROL NUMBER: 56-AS-20240619083431
FACILITY NAME:JASMIN TERRACE AT YUCCA VALLEYFACILITY NUMBER:
361880801
ADMINISTRATOR:MICHAEL GARCIAFACILITY TYPE:
740
ADDRESS:55425 SANTA FE TRAILTELEPHONE:
(760) 365-0887
CITY:YUCCA VALLEYSTATE: CAZIP CODE:
92284
CAPACITY:85CENSUS: 63DATE:
01/09/2026
UNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Assistant DIrector, Maria MolinaTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Staff did not prevent inappropriate resident behavior
Staff did not safeguard resident's personal items
Staff do not assist resident when called upon
Staff did not accord resident dignity in their relationship with staff or other persons
Staff do not ensure that residents are appropriately dressed
Staff do not give resident medication as prescribed
Facility is in disrepair
INVESTIGATION FINDINGS:
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On 01/09/2026 at 10:20AM 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 the Asssitant Administrator, Maria Molina and Administrator, Michael Garcia. The investigation consisted of interviews, observation and record review.

In regards to the allegation of staff did not prevent inappropriate resident behavior:
LPA interviewed six (6) staff , seven (7) residents and the relatives of two (2) residents. Staff denied the allegation and stated that they redirect residents when needed. Residents stated that staff are available to assist and the residents get along. Based on interviews, this allegation is UNSUBSTANTIATED.

In regards to the allegation of staff did not safeguard resident's personal items:
Staff stated that the independent residents are responsible for their own valuables and their rooms have locks. For residents safety in memory care, rooms remain unlocked.



Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2026
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 2
Control Number 56-AS-20240619083431
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: JASMIN TERRACE AT YUCCA VALLEY
FACILITY NUMBER: 361880801
VISIT DATE: 01/09/2026
NARRATIVE
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 The facility encourages family not to bring valuable items to the facility. Based upon interviews and observation, this allegation is UNSUBSTANTIATED.

In regards to the allegation that staff do not assist resident when called upon:
Staff stated that all residents are checked every two (2) hours. All of the resident rooms have working call buttons. Seven (7) out of seven (7) residents interviewed stated that staff assist when they need help. Based upon interview, this allegation is UNSUBSTANTIATED.

In regards to the allegation of staff did not accord resident dignity in their relationship with staff or other persons:
Staff denied the allegation and stated that staff treat all of the residents with respect. The residents that were interviewed stated that staff treat them well. Based on interview, this allegation is UNSUBSTANTIATED.

In regards to the allegation of staff do not ensure that residents are appropriately dressed:
LPA observed the temperature in the facility to be comfortable and residents were wearing appropriate and clean clothing. Staff stated that before residents leave the facility, they ensure residents have what they need based on the weather. Based on interview and observation, this allegation is UNSUBSTANTIATED.

In regards to the allegation of staff do not give resident medication as prescribed:
LPA observed the Medication Administration Record (MAR) for Resident 1 (R1) and did not observe any discrepancies. Staff stated the they have regular training on medication and give the medication as prescribed. Based on interview and observation, this allegation is UNSUBSTANTIATED.

In regards to the allegation of the facility is in disrepair:
LPA observed the facility to be clean with no visible safety hazards. LPA observed staff with cleaning carts moving throughout the facility. LPA also observed various receipts confirming maintenance supply purchases. Based on observation and record review, this allegation is 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(s) occurred.

An exit interview was conducted where this report LIC9099 and LIC9099C were discussed and copies were provided to Administrator, Michael Garcia.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2