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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361880801
Report Date: 03/25/2026
Date Signed: 03/25/2026 02:34:20 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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
07/01/2024 and conducted by Evaluator Magda Malcore
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240701121842
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:
03/25/2026
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Michael GarciaTIME COMPLETED:
02:40 PM
ALLEGATION(S):
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Staff spoke inappropriately to resident
Staff yelled at resident
Staff did not ensure the electricity in resident's room was not in disrepair
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced visit to the facility to conclude the complaint investigation on the above allegations. LPA met with Administrator, Michael Garcia, and explained the purpose of the visit. The investigation consisted of LPA observations, record review, interviews with residents and staff.

Regarding the allegation, staff spoke inappropriately to resident, five (5) out of six (6) resident interviews indicated that staff have not spoken inappropriately to them. Six (6) staff interviews indicated that they have not spoken inappropriately to a resident.

Regarding the allegation, staff yelled at a resident, five (5) out of six (6) resident interviews indicated that staff have not yelled at them. Six (6) staff interviews indicated that they have not yelled at a resident.
***continued on LIC9099-C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2026
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 5
Control Number 56-AS-20240701121842
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: JASMIN TERRACE AT YUCCA VALLEY
FACILITY NUMBER: 361880801
VISIT DATE: 03/25/2026
NARRATIVE
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Regarding the allegation, staff did not ensure the electricity in resident's room was not in disrepair, LPA conducted observations of six (6) resident bedrooms. LPA observed that the electricity in the residents’ bedrooms and bathrooms was working properly. Six (6) residents interviewed confirm that the electricity in their bedroom and bathroom is working properly.

Based on the Department’s investigation, the allegations: Staff spoke inappropriately to resident, Staff yelled at resident, and Staff did not ensure the electricity in resident's room was not in disrepair are Unsubstantiated. An Unsubstantiated finding means, although the allegation(s) may have happened or is/are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur.

An exit interview was conducted where reports (LIC9099 & LIC9099-C) was discussed and provided to Administrator Garcia.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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
07/01/2024 and conducted by Evaluator Magda Malcore
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240701121842

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:
03/25/2026
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Michael GarciaTIME COMPLETED:
02:40 PM
ALLEGATION(S):
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Staff did not ensure resident's medical needs were met
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced visit to the facility to conclude the complaint investigation on the above allegation. LPA met with Administrator, Michael Garcia, and explained the purpose of the visit. The investigation consisted of LPA observations, record review, interviews with residents and staff.

Regarding the allegation, staff did not ensure resident’s medical needs were met: It was alleged that facility staff were not meeting resident#1 (R1's) medical appointment needs. LPA reviewed the facility’s medical appointment log. The log revealed that (R1) had a schedule appointment on October 31, 2025, with a written entry indicating that the appointment was missed. Staff#1 (S1), who was responsible for transporting R1, thought the appointment was at a later time and did not take R1 to the appointment.

Based on the Department’s investigation, the allegation: staff did not ensure resident’s medical needs were met, is Substantiated. **continued on LIC9099-C**
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 56-AS-20240701121842
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: JASMIN TERRACE AT YUCCA VALLEY
FACILITY NUMBER: 361880801
VISIT DATE: 03/25/2026
NARRATIVE
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A finding that the complaint is Substantiated means that the allegation(s) is valid because the preponderance of the evidence standard has been met.

An exit interview was conducted where reports (LIC9099, LIC9099-C, LIC9099-D) were discussed. Report copies were provided with appeal rights to the Administrator Garcia.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 56-AS-20240701121842
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: JASMIN TERRACE AT YUCCA VALLEY
FACILITY NUMBER: 361880801
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/25/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/31/2026
Section Cited
CCR
87465(a)(2)
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87465(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 available medical or dental facility which will meet the resident's need…This requirement is not met at evidenced by:
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The Licensee/Administrator has agreed to provided staff inservice training on ensuring resident medical/transportation needs are met. Proof of training to be submitted to the licensing agency by POC due date.
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The Licensee did not comply with the section cited above, as staff #1(S1) did not ensure resident #1 (R1) was transported to their medical appointment as scheduled; which poses a potential health, safety, and personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5