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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 365530138
Report Date: 05/19/2026
Date Signed: 05/19/2026 11:26:59 AM

Substantiated


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
11/06/2025 and conducted by Evaluator Renese Howell-Small
COMPLAINT CONTROL NUMBER: 56-AS-20251106091708
FACILITY NAME:WHITE HOUSE, THEFACILITY NUMBER:
365530138
ADMINISTRATOR:BICKHAM, EDDIEFACILITY TYPE:
735
ADDRESS:15363 PATTON STTELEPHONE:
(760) 596-0749
CITY:VICTORVILLESTATE: CAZIP CODE:
92394
CAPACITY:4CENSUS: 4DATE:
05/19/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:House Manager, Bridie HolmesTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff touched resident inappropriately
INVESTIGATION FINDINGS:
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On 05/19/2026 Licensing Program Analyst (LPA) Renese Howell-Small conducted an unannounced visit to the facility to deliver findings for the above allegation. LPA discussed the purpose of the visit with House Manager, Bridie Holmes.

The allegation that staff touched resident inappropriately is SUBSTANTIATED.

Based on interview, Client 1 (C1) stated that Staff 2 (S2) brushed and touched two different parts of their body. Client 2 (C2) observed S2 was alone with C1 and informed Staff 3 (S3). Interviews conducted with S3 and Staff 4 (S4) stated that the facility policy is for two (2) staff to assist C1. Staff believed the allegation to be true because S2 was observed to be more physical with female staff. S2 was reminded by S3 and S4 of the facility policy. S2's employment was terminated on 11/2025 due to misconduct. S2 did not deny the allegation, however, S2 admitted to "tucking" C1 into bed. S2 was contacted, however LPA was unable to conduct an interview. Based upon interview, this allegation is SUBSTANTIATED.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2026
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 3
Control Number 56-AS-20251106091708
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: WHITE HOUSE, THE
FACILITY NUMBER: 365530138
VISIT DATE: 05/19/2026
NARRATIVE
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SUBSTANTIATED is defined as the complaint allegation(s) is valid and a violation has occurred based on the preponderance of available evidence. A deficiency will be cited.

An exit interview was conducted where this report LIC9099, LIC9099D and Appeal Rights were discussed, and a copy was provided to House Manager, Bridie Holmes.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 56-AS-20251106091708
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: WHITE HOUSE, THE
FACILITY NUMBER: 365530138
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/19/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/20/2026
Section Cited
CCR
80072(a)(1)
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80072 Personal Rights (a)(1) (a) Except for children’s residential facilities, each client shall have personal rights which include...(1) To be accorded dignity in his/her personal relationships with staff...
This requirement was not met as evidenced by:
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The Administrator will review section 80072, sign a statement of understanding and conduct a staff training on Personal Rights with an emphasis in professional conduct by Plan of Correction (POC) due date.
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Based upon interview, the facility did not ensure that Staff 2 (S2) followed the facility policy by assisting specific clients with an additional staff and was observed alone with Client 1 (C1), which posed an immediate risk to the health and safety of residents 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: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3