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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 365530213
Report Date: 11/13/2025
Date Signed: 11/13/2025 04:01:32 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
08/21/2025 and conducted by Evaluator Renese Howell-Small
COMPLAINT CONTROL NUMBER: 56-AS-20250821170913
FACILITY NAME:VILLAS AT SAN BERNARDINOFACILITY NUMBER:
365530213
ADMINISTRATOR:CARLTON, KENYAFACILITY TYPE:
740
ADDRESS:2985 N G STREETTELEPHONE:
(323) 475-1800
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92405
CAPACITY:144CENSUS: 91DATE:
11/13/2025
ANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Resident Services Director, Dulce AllenTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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The facility does not have enough staff for care and supervision of the residents in care
The facility is dirty in memory care
The laundry services were not done for the residents
The facility does not provide showers for residents
INVESTIGATION FINDINGS:
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On 11/13/025 at 10:00AM Licensing Program Analyst (LPA) Renese Howell-Small conducted an unannounced visit to the facility in order to deliver findings for the above allegations. LPA discussed the purpose of the visit with Resident Services Director, Dulce Allen. The investigation consisted of interviews, observation and record review.

In regards to the allegation of the facility does not have enough staff for care and supervision of the residents in care:
LPA interviewed six (6) staff and reviewed the staffing schedule. Staff stated that there is sufficient staff and when a staff is out, they work as a team to care for residents. The facility is staffed based upon the level of care of the residents. Based on interviews and record review this allegation is UNSUBSTANTIATED.

In regards to the allegation of the facility is dirty in memory care:
LPA interviewed six (6) staff, reviewed the housekeeping schedule and observed that upon each visit to the facility, staff were cleaning the halls, resident rooms and bathrooms. Based upon interviews and observation, this allegation is UNSUBSTANTIATED.



Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
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-20250821170913
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: VILLAS AT SAN BERNARDINO
FACILITY NUMBER: 365530213
VISIT DATE: 11/13/2025
NARRATIVE
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In regards to the allegation of the laundry services were not done for the residents:
The facility's Admission's Agreement states that they will provide laundry services once per week or more if needed. Staff stated that they launder the residents' items weekly and as needed. LPA observed that Resident 1 (R1) did not have any laundry in their hamper during today's visit. Based upon interview and observation, this allegation is UNSUBSTANTIATED.

In regards to the allegation of the facility does not provide showers for residents:
LPA reviewed R1's care plan and the facility's shower log. R1 has two (2) showers planned each week. However, a review of the shower log revealed that R1 has refused showers. Based upon record review, this allegation is UNSUBSTANTIATED.

UNSUBSTANTIATED is defined as the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted where this report LIC9099 and LIC9099C was discussed and a copies were provided to Resident Services Director, Dulce Allen.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
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