361880801-8-7-2026-56-AS-KCLS-DWXT6Y-20260814142755

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361880801
Report Date: 08/07/2026
Date Signed: 08/07/2026 12:24:22 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
11/08/2024 and conducted by Evaluator Magda Malcore

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20241108092028

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: 65	DATE:	08/07/2026
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Michael Garcia		TIME COMPLETED:	12:25 PM

ALLEGATION(S):

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Resident sustained unexplained injury while in care
Staff did not bathe resident in care
Staff did not report incident to resident's authorized representative
Staff do not ensure resident's hydration needs are met.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced visit to conclude the investigation on the above allegations. LPA met with Administrator, Michael Garcia, and informed the purpose of the visit. The investigation consisted of pertinent document review, and interviews with residents and staff.

Regarding the allegation, Resident sustained unexplained injury while in care, it was alleged that resident#1 (R1) had an unexplained body injury. There is not enough evidence to corroborate this allegation. Staff interviewed deny that (R1) had sustained unexplained injuries while in care. (R1) refused LPA's interview attempt.

Regarding the allegation, Staff did not bathe resident in care, it was alleged that staff did not bathe (R1). Staff interviewed denied not providing or assisting any residents with baths; however, R1 would refuse baths. R1 also refused LPA’s attempt to interview.

**continued on LIC9099-C**

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2026

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-20241108092028

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: 08/07/2026

NARRATIVE

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Interviews with six (6) residents reveal that they either they do not require staff assistance with bathing/showers or that staff do provide baths/showers.

Regarding the allegation, Staff did not report incident to resident's authorized representative, it was alleged that staff did not report an unexplained injury to (R1’s) authorized representative. Staff interviewed denied failing to report injuries to any resident’s authorized representative. Staff stated that when injuries occur, they are documented, reported to a medtech, and reported to resident’s responsible party. R1 refused LPA’s interview attempt.

Regarding the allegation, Staff do not ensure resident's hydration needs are met, it was alleged that (R1) was not provided with drinking water. During LPA’s tour of facility, LPA observed a water pitcher placed on the R1’s nightstand in their bedroom. Staff interviewed denied failing to ensure that any resident’s hydration needs were met. Staff stated that water and other beverages are routinely offered to residents, and hydration provided is documented. Interviews with six (6) residents indicate that staff offer water or coffee to them and their hydrations needs are met.

Based on the Department’s investigations, the allegations are deemed Unsubstantiated. An Unsubstantiated finding means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation(s) did or did not occur.

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

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2026

LIC9099 (FAS) - (06/04)

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