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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361881272
Report Date: 04/09/2026
Date Signed: 04/09/2026 02:43:07 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
01/28/2026 and conducted by Evaluator Paola Guerrero
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20260128102256
FACILITY NAME:ST. CLARE FAMILY HOMEFACILITY NUMBER:
361881272
ADMINISTRATOR:SANCHEZ,ANTONIOFACILITY TYPE:
735
ADDRESS:2608 GARFIELD AVENUETELEPHONE:
(909) 295-9740
CITY:ONTARIOSTATE: CAZIP CODE:
91761
CAPACITY:4CENSUS: 2DATE:
04/09/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Antonio SanchezTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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9
Staff did not abide to the admission agreement
Staff are not meeting a resident's medical needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Paola Guerrero arrived at the facility to deliver investigative findings. LPA met with Facility Administrator Antonio Sanchez and explained the purpose of the visit regarding the allegations stated above.

First allegation: Staff did not abide to the admission agreement. Regarding the allegation stated above, LPA conducted a review of records and discovered that on 10/8/2025 LPA delivered substantial findings to similar allegation however, different sequence of event pertaining to Client #1. While reviewing records LPA observed that Client #1 was issued a prescribed diet on April 17,2025 prior to R#1 admission. LPA also discovered that the facility did not have a set nutritionist designated to Client #1 to meet client’s dietary needs according to Client #1 physician’s orders. In addition, LPA also observed that a set menu adhering to client’s needs was not finalized or set in place according to the needs of the client.

Second allegation: Staff are not meeting a resident's medical needs.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026
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-20260128102256
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: ST. CLARE FAMILY HOME
FACILITY NUMBER: 361881272
VISIT DATE: 04/09/2026
NARRATIVE
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Regarding the allegation stated above, LPA conducted a review of records pertaining to Client #1 upon the review of records LPA discovered that upon client’s admission on 5/1/2025, the facility did not adhere to or put into place a set dietary menu for Client #1 according to client’s needs based on client’s physician report and clients’ orders. In addition, during review of records LPA observed that as of 7/7/2025, and Individual Program Plan (IPP), was not yet set into place for Client #1. Furthermore, upon further review LPA discovered that as of 12/17/2025, there was still concerns with finding Client #1 with a constant dietitian. Based on the evidence gathered during the investigation, the above allegations are Substantiated. A finding that the complaint is Substantiated means that the findings are valid because the preponderance of the evidence standard has been met. Title 22 regulations Admission Procedures 85068.1 (a)(b) & (2), from division 6, chapter, article 6, is, cited on the attached LIC 9099 D.

An exit interview was conducted where this report, appeal rights, and LIC9099-D was discussed, and a copy of the report was provided to Facility Administrator Antonio Sanchez at the conclusion of the visit.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 56-AS-20260128102256
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: ST. CLARE FAMILY HOME
FACILITY NUMBER: 361881272
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/17/2026
Section Cited
CCR
85068.1(a)(b)
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Admission Procedures....(a) The licensee shall develop, maintain, and implement admission procedures which shall meet the requirements specified in this section....(b) No client may be admitted prior to a determination of the facility's ability to meet the needs of the client, which must include an appraisal of his/her individual service needs as specified in Sections 80068.2 and 85068.2.

This Requirement is not met as evidence by:
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The Licensee has agreed to read over the indicated regulation and shall provide training to all administrators and acting administrators about the procedures of admission and the ability to meet the needs of a client prior to admission. The Licensee will email proof of the training to the designated LPA by POC date. 4/17/2026.
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Based on record review, the licensee did not adhere to the admission procedures by admitting Client #1 into the facility and not adhering to client's dietary needs, which poses an immediate Health, Safety, or Personal Rights risk to clients in care.
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Type B
04/17/2026
Section Cited
CCR
85068.1(b)(2)
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Admission Procedures.... (b) No client may be admitted prior to a determination of the facility's ability to meet the needs of the client, which must include an appraisal of his/her individual service needs as specified in Sections 80068.2 and 85068.2. ...(2) Develop a Needs and Services Plan as specified in Sections 80068.2 and 85068.2.

This Requirement is not met as evidence by:



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The Licensee has agreed to read over the indicated regulation and shall provide training to all staff and acting administrators about the procedures of admission and the ability to meet the needs of a client according to their individual medical requirements prior to admission. The Licensee will email proof of the training to the designated LPA by POC date. 4/17/2026.
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Based on record review, the licensee did not adhere to the admission procedures by admitting Client #1 into the facility and not adhering to client's medical needs, which poses an immediate Health, Safety, or Personal Rights risk to clients 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: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026
LIC9099 (FAS) - (06/04)
Page: 3 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
01/28/2026 and conducted by Evaluator Paola Guerrero
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20260128102256

FACILITY NAME:ST. CLARE FAMILY HOMEFACILITY NUMBER:
361881272
ADMINISTRATOR:SANCHEZ,ANTONIOFACILITY TYPE:
735
ADDRESS:2608 GARFIELD AVENUETELEPHONE:
(909) 295-9740
CITY:ONTARIOSTATE: CAZIP CODE:
91761
CAPACITY:4CENSUS: 3DATE:
04/09/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Antonio SanchezTIME COMPLETED:
02:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Administrator is not at the facility the required amount of time
Staff are mishandling a resident's personal funds
Licensee does not ensure that a designated substitute is present at the facility during Administrator's absence
Staff have an adequate record keeping for a resident
Staff are not providing authorized representative access to a resident's records
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Paola Guerrero arrived at the facility to deliver investigative findings. LPA met with Facility Administrator Antonio Sanchez and explained the purpose of the visit regarding the allegations stated above.

First allegation: Administrator is not at the facility the required amount of time. Regarding the allegation LPA conducted interviews with S#1 and S#2 regarding the allegation stated above and Staff #1 and Staff #2 informed LPA that the Facility Administrator is at the facility for the required time. In addition, Staff #1 and Staff #2 informed LPA that the facility Administrator is always available when needed. LPA conducted an interview with facility administrator who informed LPA that the administrator is always available when needed. In addition, Administrator also stated that the facility always has someone available if the appointed administrator is not available.

Second allegation:
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 56-AS-20260128102256
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: ST. CLARE FAMILY HOME
FACILITY NUMBER: 361881272
VISIT DATE: 04/09/2026
NARRATIVE
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 Staff are mishandling a resident's personal funds. Regarding the allegation stated above, LPA conducted a review of records pertaining to Client #1 upon the review and count of clients LIC 405 (cash resources), LPA observed that as of 1/29/2026 Client #1 had a total balance of $69.00 dollars of cash resources available for client to use. In addition, LPA also observed that on 1/18/2026 Client #1 utilized $50.00 from their cash resources to pay for a haircut. LPA observed cash resources to be available for Client #1.
Third allegation: Licensee does not ensure that a designated substitute is present at the facility during Administrator's absence. Regarding the allegation stated above LPA conducted a review of records during the review of records LPA discovered that on 12/30/2025 Administrator Antonio Sanchez informed the department regarding his absence. During review of record LPA also discovered that Antonio provided the department with administrator’s certificates, Designation of Facility Responsibility (LIC 308) contact information, and email address for the person[s] who will be acting as the administrator during Antonio’s absence.

Fourth allegation: Staff have an adequate record keeping for a resident. Regarding the allegation stated above, LPA conducted an Interview with Staff #3 regarding the alleged allegation. LPA was informed by Staff #3 that all files are kept locked and secured inside staff office. LPA conducted an inspection and observed files to be locked and secured inside staff office. LPA Informed Staff #3 that a client file inspection will be conducted. During the file inspection LPA observed that clients’ physical files were complete, accurate, and intact. During further inspection LPA observed that the proper equipment such as shredder, fax, scan/copy machine were present in staff office protecting sensitive and personal documentation pertaining to each client. According to Tile 22 there is no regulation in place that indicates that a licensee should keep logs/or records when transmitting documents over to other industries or agencies.

Fifth Allegation: Staff are not providing authorized representative access to a resident's records. Regarding the allegation stated above, LPA conducted an interview with Staff #4 regarding the alleged allegation Staff #3 informed LPA that behavior logs for each client are recorded and tallied at the end of each month. Staff #3 also informed LPA that the documentation that was being requested was during the middle of the month, in which longs and tallies are recorded at the end of each month. Staff #3 further explained that records were not being withheld, staff indicated If a request is made to see the logs, they are readily available however records will be incomplete if requested before the end of the month. Based on corroborating evidence LPA has determined that the above allegations are Unsubstantiated, meaning that 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) was discussed, and a copy was provided to Facility Administrator Antonio Sanchez.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5