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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361880948
Report Date: 05/20/2025
Date Signed: 05/20/2025 03:25:36 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
01/23/2025 and conducted by Evaluator Lavette Farlow
COMPLAINT CONTROL NUMBER: 56-AS-20250123160953
FACILITY NAME:VNL ARF II INCFACILITY NUMBER:
361880948
ADMINISTRATOR:ANN CLARKFACILITY TYPE:
735
ADDRESS:1205 W. BOHNERT AVETELEPHONE:
(909) 990-0299
CITY:RIALTOSTATE: CAZIP CODE:
92377
CAPACITY:4CENSUS: 4DATE:
05/20/2025
UNANNOUNCEDTIME BEGAN:
02:27 PM
MET WITH:Licensee Ann Clark and Administrator Michael ClarkTIME COMPLETED:
03:22 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff are neglecting clients
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) LaVette Farlow conducted a scheduled in office visit to conclude the investigation and deliver findings to the above-mentioned complaint. LPA met with Facility Licensee, Ann Clark and Administrator Michael Clark who was informed of the reason for today's visit. The investigation consisted of interviews with residents, staff, and review of records.

It is alleged that facility staff are neglecting clients. LPA Farlow interview three (3) out of four (4) clients in care. Interviews with clients C1, C2, and C3 revealed that clients are happy in the home and feel that staff treat them good. Three (3) out of three (3) residents stated staff assist them as needed, staff take them to doctors’ appointments, staff provide meals, and staff take residents on outings. LPA Farlow interviewed five (5) staff. Interviews with five (5) out of five (5) revealed staff are not abusing or neglecting resident in care. 5 out of 5 staff stated they have not neglected or abused residents in care. 5 out of 5 staff stated they have not observed any staff abusing or neglecting residents or staff.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
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-20250123160953
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: VNL ARF II INC
FACILITY NUMBER: 361880948
VISIT DATE: 05/20/2025
NARRATIVE
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27
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32
Based on the information above, the allegation is unsubstantiated. A finding of UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted where this report LIC 9099 and LIC 9099C was discussed, and a copy was provided to Licensee, Ann Clark and Administrator Michael Clark.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2