365530015-3-27-2026-56-AS-KCLS-DSZPQA-20260410113048

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 365530015
Report Date: 03/27/2026
Date Signed: 03/27/2026 01:53:12 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
03/03/2026 and conducted by Evaluator Eldin Serrano

COMPLAINT CONTROL NUMBER: 56-AS-20260303093650

FACILITY NAME:	ZION ADULT RESIDENTIAL FACILITY 2		FACILITY NUMBER:	365530015
ADMINISTRATOR:	UNIQUE WATKINS		FACILITY TYPE:	735
ADDRESS:	12641 GARDEN WAY		TELEPHONE:	(951) 305-5308
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92395
CAPACITY:	4	CENSUS: 4	DATE:	03/27/2026
		UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Breana Holloway, House Manager		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Personal rights.
Facility is not meeting the residents needs.

INVESTIGATION FINDINGS:

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On 3/27/2026 at 1:20PM, Licensing Program Analyst (LPA) Eldin Serrano made an unannounced visit to the facility to investigate and deliver the findings of the above allegations. LPA met with house Manager Breanna Holloway to explain the purpose of the visit.The investigation consisted of file review, interviews with facility staff and residents as well as facility observation.

Allegation #1: Personal rights. – Based on interviews, three out of four clients and both staff confirmed that the facility treats individuals with dignity in their personal relationship with staff, residents and other persons. They reported no food restrictions, no unfair treatment, or negative interactions with facility staff. Therefore, the allegation could not be substantiated.

Allegation #2: Facility is not meeting the residents needs. - Based on interviews, 3 of 4 clients and both staff interviewed confirmed that the facility meets clients’ needs. Clients revealed they can request food outside of the posted menu, snacks are made available between meals, and staff make reasonable efforts to accommodate client preferences. LPA was unable to corroborate the allegation.
*** Continuation in LIC9099C ***

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Eldin Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2026

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-20260303093650

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: ZION ADULT RESIDENTIAL FACILITY 2	FACILITY NUMBER: 365530015
	VISIT DATE: 03/27/2026

NARRATIVE

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Information received during investigation LPA did not find evidence to corroborate the allegations.

Based on the evidence, the allegations mentioned above are UNSUBSTANTIATED. A finding that the complaint is 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, therefore the allegation is unsubstantiated at this time.

An exit interview was conducted where this report, LIC9099 and LIC9099C were discussed and provided to House Manager Breanna Holloway

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Eldin Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2026

LIC9099 (FAS) - (06/04)

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