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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361880801
Report Date: 03/16/2026
Date Signed: 03/16/2026 04:08:24 PM

Substantiated


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
03/12/2026 and conducted by Evaluator Magda Malcore
COMPLAINT CONTROL NUMBER: 56-AS-20260312160937
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:
03/16/2026
UNANNOUNCEDTIME BEGAN:
02:41 PM
MET WITH:Maria Molina & Michael GarciaTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Facility staff did not ensure carpets in residents’ bedrooms were maintained clean
Facility staff did not maintain sink faucets in residents’ bedrooms in good repair
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced visit to the facility to initiate a complaint investigation on the above allegations. LPA met with Assisting Administrator Maria Molina and Administrator Michael Garcia and explained the purpose of the visit. The investigation consisted of LPA observations and interviews with residents and staff.

Regarding the allegation, facility staff did not ensure carpets in residents’ bedrooms were maintained clean, LPA observed that the carpet in resident bedrooms 108, 109, and 123 was visibly soiled with dark stains. The Administrator and one (1) staff interviews reveal carpets are not routinely checked for cleanliness; instead, they are cleaned as needed or upon request.

Regarding the allegation, facility staff did not maintain sink faucets in residents’ bedrooms in good repair, LPA observed that the sink faucet in resident bedroom 109 was continuously leaking. LPA also noted that the cold water side was not operating, as no water came out when the faucet was turned on. Interviews with two (2) staff members revealed that they became aware of the leak approximately one month ago, and maintenance had tightened the hot water side at that time.
***continued on LIC9099-C***
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2026
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
Control Number 56-AS-20260312160937
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: 03/16/2026
NARRATIVE
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Today, the two (2) staff members discovered that the sink was still leaking and that the cold water side was not functioning properly. The resident in bedroom 109 confirm that the faucet had been leaking for about a month.

Based on the Department’s investigation, the allegations mentioned in this report are Substantiated. Substantiated meaning that the allegation(s) is/are valid because the preponderance of the evidence standard has been met.

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

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

DATE: 03/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 56-AS-20260312160937
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: 03/16/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/31/2026
Section Cited
CCR
87303(a)
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87303(a)The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by:
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During today's visit, LPA observed the sink faucet in bedroom #109 was repaired.
The Administrator stated that the carpets in bedrooms #108, 109, and 123 will be replaced by POC due date. Proof of correction shall be submitted to the licensing agency by POC due date.
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The Licensee did not comply with the section cited above by not ensuring that resident bedroom carpets in rooms108, 109, and 123 were clean and the sink faucet in resident bedroom #109 was operating properly; which poses an 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: 03/16/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2026
LIC9099 (FAS) - (06/04)
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