361880801-3-25-2026-56-AS-KCLS-DTMP3U-20260430105807

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361880801
Report Date: 03/25/2026
Date Signed: 03/25/2026 01:23:47 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
05/27/2025 and conducted by Evaluator Magda Malcore

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20250527134209

FACILITY NAME:	JASMIN TERRACE AT YUCCA VALLEY		FACILITY NUMBER:	361880801
ADMINISTRATOR:	MICHAEL GARCIA		FACILITY TYPE:	740
ADDRESS:	55425 SANTA FE TRAIL		TELEPHONE:	(760) 365-0887
CITY:	YUCCA VALLEY	STATE: CA	ZIP CODE:	92284
CAPACITY:	85	CENSUS: 63	DATE:	03/25/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Michael Garcia		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Facility staff are not ensuring resident is adequately fed resulting in weight loss
Facility staff did not appropriately safeguard resident's personal belongings
Facility hallways floors in memory care are not maintained clean and sanitary

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 that facility staff are not ensuring the resident is adequately fed, resulting in weight loss, it was alleged that staff were not ensuring that Resident #1 (R1) was adequately fed. An interview with R1 revealed that they are provided a sufficient amount of food and are able to feed themselves without assistance. Staff interviews confirmed that R1 is able to feed themself; however, staff provide verbal reminders when meals are being served. Review of R1’s medical assessment dated May 2025 indicates R1 appeared well and well nourished. Additionally, the medical assessment from March 2026 reflects that R1 was in good physical health.
***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)

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Control Number 56-AS-20250527134209

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 that facility staff did not appropriately safeguard the resident’s personal belongings: It was alleged that one of R1’s clothing items was missing and had not been returned. Staff interviews revealed that residents clothing items are labeled with the resident’s name or initials for identification. LPA observed that R1’s clothing items were properly labeled. During the investigation, LPA observed R1 wearing the shirt that had been described and reported as missing.

Regarding the allegation, facility hallways floors in memory care are not maintained clean and sanitary: LPA observed the hallway floors in the memory care unit to be clean, and no malodorous odors were noted. Staff interviews indicate that the hallway floors are cleaning daily. Resident interviews indicate that the hallways floors are maintained clean.

Based on the Department’s investigation, the allegations mentioned in this report are Unsubstantiated. A finding of Unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted where this report was discussed. A copy of this report with appeal rights was 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)

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