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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 365530263
Report Date: 07/17/2026
Date Signed: 07/17/2026 02:59:01 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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 Paola Guerrero
COMPLAINT CONTROL NUMBER: 56-AS-20260303131534
FACILITY NAME:VALLEY CRESTFACILITY NUMBER:
365530263
ADMINISTRATOR:JORDAN, KIMBERLYFACILITY TYPE:
740
ADDRESS:18524 CORWIN RDTELEPHONE:
(760) 242-3188
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92307
CAPACITY:65CENSUS: 44DATE:
07/17/2026
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Donna CabreraTIME COMPLETED:
03:10 PM
ALLEGATION(S):
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Staff do not ensure resident is allowed phone calls
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Paola Guerrero arrived at the facility to deliver investigative findings. LPA met with Facility Administrator Donna Cabreraand explained the purpose of the visit regarding the allegations stated above.

First allegation: Staff do not ensure resident is allowed phone calls. Regarding the allegation stated above, LPA conducted an interview with Staff #1 regarding the alleged allegation Staff #1 informed LPA that since Resident #1 admission (2/17/2026), resident was receiving multiple calls. Staff #1 informed LPA that staff informed Resident #1 family that calls were becoming excessive and conflicting with Resident #1 schedule. Staff #1 informed LPA that staff suggested Resident #1 family for a solution regarding the excessive calls. Staff #1 provided LPA with call logs that showed the multiple calls Resident #1 received. LPA informed Staff #1 if the call log demonstrate Resident #1 refusing any telephone call Staff #1 stated “No”. LPA informed Staff #1 that all residents have the right to have reasonable access to telephones, to both make and receive confidential calls.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2026
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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 Paola Guerrero
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20260303131534

FACILITY NAME:VALLEY CRESTFACILITY NUMBER:
365530263
ADMINISTRATOR:JORDAN, KIMBERLYFACILITY TYPE:
740
ADDRESS:18524 CORWIN RDTELEPHONE:
(760) 242-3188
CITY:APPLE VALLEYSTATE:CAZIP CODE:
92307
CAPACITY:65CENSUS: 44DATE:
07/17/2026
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Donna CabreraTIME COMPLETED:
03:10 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not assisting resident with medical needs
Staff do not ensure resident's hygiene needs are being met
INVESTIGATION FINDINGS:
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5
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13
Licensing Program Analyst (LPA) Paola Guerrero arrived at the facility to deliver investigative findings. LPA met with Facility Administrator Donna Cabrera and explained the purpose of the visit regarding the allegations stated above.

First allegation: Staff are not assisting resident with medical needs. Regarding the allegation stated above, LPA conducted an interview with Staff #1-3 regarding the alleged allegation and Staff #1-3 denied the allegation and informed LPA that Resident #1 was provided with medical care needs daily. LPA conducted interviews with Residents #2-5 regarding the alleged allegation and all residents denied the allegation and informed LPA that all their medical needs are being met and have no concerns to report.

Second allegation: Staff do not ensure resident's hygiene needs are being met. Regarding the allegation stated above, LPA conducted an interview with Staff #1-3 regarding the alleged allegation and Staff #1-3 denied the allegation and informed LPA that Resident #1 hygiene needs were being met daily.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 56-AS-20260303131534
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: VALLEY CREST
FACILITY NUMBER: 365530263
VISIT DATE: 07/17/2026
NARRATIVE
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Based on the evidence gathered during the investigation, the above allegations are Substantiated. A finding that the complaint is Substantiated means that the findings are valid because the preponderance of the evidence standard has been met. Title 22 Regulations Personal Rights of Residents in All Facilities 87468.1 (a)(1)(3)(14), from division 6, chapter, article 6, is, cited on the attached LIC 9099 D.

An exit interview was conducted where this report, appeal rights, and LIC9099-D was discussed, and a copy of the report was provided to Facility Administrator Donna at the conclusion of the visit.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 56-AS-20260303131534
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: VALLEY CREST
FACILITY NUMBER: 365530263
VISIT DATE: 07/17/2026
NARRATIVE
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LPA conducted interviews with Residents #2-5 regarding the alleged allegation and all residents denied the allegation and informed LPA that caregivers assist them with their hygiene needs daily and that they have no concerns regarding their hygiene needs. Based on corroborating evidence LPA has determined that the above allegation is Unsubstantiated, meaning that 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.

An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Administrator Donna Cabrera
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 56-AS-20260303131534
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: VALLEY CREST
FACILITY NUMBER: 365530263
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/17/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/24/2026
Section Cited
CCR
87468.1(a)(1)(3)(14)
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Personal Rights of Residents in All Facilities 87468.1 ....(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:....(1) To be accorded dignity in their personal relationships with staff, residents, and other persons....(3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination.....(14) To have reasonable access to telephones, to both make and receive confidential calls. The licensee may require reimbursement for long distance calls.

This requirement is not met as evidence by:
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The Licensee has agreed to provide training on regulation: Personal Rights of Residents in All Facilities 87468.1 (a)(1)(3)(14). The Licensee will provide LPA proof of the training that will be signed and dated by all staff by POC date 7/24/2026.
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Based on interviews, and review of records, the Licensee did not adhere to the regulation stated above for Resident #1, which poses an immediate Health, Safety, or Personal Rights risks to 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.
SUPERVISOR'S NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5