365530213-3-26-2025-56-AS-NBRN-DHTUCP-20250620152817

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 365530213
Report Date: 03/26/2025
Date Signed: 03/26/2025 01:02:32 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
02/24/2025 and conducted by Evaluator Renese Howell-Small

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20250224112022

FACILITY NAME:	VILLAS AT SAN BERNARDINO		FACILITY NUMBER:	365530213
ADMINISTRATOR:	CARLTON, KENYA		FACILITY TYPE:	740
ADDRESS:	2985 N G STREET		TELEPHONE:	(323) 475-1800
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92405
CAPACITY:	144	CENSUS: 84	DATE:	03/26/2025
		UNANNOUNCED	TIME BEGAN:	09:11 AM
MET WITH:	Executive Director, Kenya Carlton		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Facility staff yell at residents
Facility staff are not meeting residents toileting needs

INVESTIGATION FINDINGS:

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On 03/26/2025 at 9:11AM Licensing Program Analyst (LPA) Renese Howell-Small conducted an unannounced visit to the facility to deliver findings for the above allegations. LPA was greeted by staff and granted entrance to the facility. LPA met with Executive Director, Kenya Calrton and discussed the purpose of the visit.

In regards to the allegation that facility staff yell at residents: LPA interviewed six (6) staff, a relative of Resident 1 (R1) and interviewed R1. All staff denied that staff yell at residents in care. Staff have recieved several trainings regarding Resident Rights and Working with Challenging Residents. In an interview with R1 on 03/03/2025, R1 denied that staff yelled at residents. Based upon interview and record review, this allegation is UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:	DATE: 03/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2025

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-20250224112022

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: 03/26/2025

NARRATIVE

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In regards to the allegation that facility staff are not meeting residents toileting needs: LPA interviewed six (6) staff and interviewed R1. R1 stated that there are no concerns and staff are meeting R1's needs. Every shift, staff complete two (2) hour checks to assist with toileting, grooming and showering needs beginning with residents who require full assistance with care and then assist the remaining residents. Facility notes confirm that R1 frequently uses the call button for assistance with toileting but may refuse assistance, then requests a different caregiver. Staff denied facility staff are not meeting residents toileting needs. R1's Admission's Agreement indicates that R1 receives full assistance with toileting needs. Based upon interview and 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, LIC9099C was discussed and a copy was provided to Executive Director, Kenya Carlton.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:	DATE: 03/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2025

LIC9099 (FAS) - (06/04)

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