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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 365530162
Report Date: 11/13/2025
Date Signed: 11/13/2025 02:21:37 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
11/12/2025 and conducted by Evaluator Beena Singh
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20251112110159
FACILITY NAME:FOOTHILL SERENITY LIVINGFACILITY NUMBER:
365530162
ADMINISTRATOR:GUEVARRA, MARYDESFACILITY TYPE:
735
ADDRESS:8024 REDWOOD AVETELEPHONE:
(909) 371-3967
CITY:FONTANASTATE: CAZIP CODE:
92336
CAPACITY:32CENSUS: 25DATE:
11/13/2025
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Facility Designee Rachelle LauretaTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Facility has bed bugs.
INVESTIGATION FINDINGS:
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First Allegation: Facility has bed bugs.

Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to the facility to initiate and deliver findings on a complaint alleging Facility has bed bugs. LPA Singh met with Facility Designee Rachelle Laureta and was granted entry into the facility. The investigation conducted by LPA Singh, consisted of observation,residents and staff interviews and reviews of pertinent records.

LPA Singh toured facility resident bedrooms and did not see any bed bugs. LPA was unable to interview R#1 due to R#1 moved out of the facility.

LPA Singh conducted interview with ten (10) residents. Ten (10) out of ten (10) residents acknowledged that the facility is taking measures to keep facility clean, including spraying resident rooms and common living areas daily.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
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-20251112110159
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: FOOTHILL SERENITY LIVING
FACILITY NUMBER: 365530162
VISIT DATE: 11/13/2025
NARRATIVE
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Interviews with two (2) staff members indicated that the facility conducts regular cleaning and maintenance activities to control bed bugs. Staff reported that contributing factors to the pest issues include residents frequently going out into the community, inconsistent personal hygiene practices among some residents and hoarding behaviors that increase the risk of pest infestation within the facility, despite facility applying house rules.

Based on the information obtained there is not enough evidence that facility has bed bugs. Therefore, the allegations that is deemed UNSUBSTANTIATED at this time.

An exit interview was conducted, and a copy of this report LIC9099, LIC9099C was provided to Facility Staff- at the conclusion of this visit.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2