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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366400985
Report Date: 07/03/2026
Date Signed: 07/03/2026 11:08:08 AM

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
12/16/2025 and conducted by Evaluator Beena Singh
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20251216091826
FACILITY NAME:ATRIA DEL REYFACILITY NUMBER:
366400985
ADMINISTRATOR:DEGUZMAN, SAMUELFACILITY TYPE:
740
ADDRESS:8825 BASELINE RDTELEPHONE:
(909) 989-4346
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91730
CAPACITY:145CENSUS: 87DATE:
07/03/2026
UNANNOUNCEDTIME BEGAN:
08:57 AM
MET WITH:Denise Naulls-Jordan-Resident Service Director.TIME COMPLETED:
11:20 AM
ALLEGATION(S):
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9
Resident sustained injuries and was not reported to family.
Facility did not give/seek proper care.
Facility charged resident family additional fees for next level care of service with out providing it.
INVESTIGATION FINDINGS:
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On 07/03/2026, Licensing Program Analyst (LPA) Beena Singh arrived to the facility to conduct a complaint investigation and delivered the findings in regards to the above allegations.


First Allegation:-Resident sustained injuries and was not reported to family.
LPA Singh conducted interview with Denise Naulls-Jordan, facility Resident Service Director who stated that facility staff ensures that residents are immidiately given first aid care after a fall or injuries, and taken to hospital if they needed to, According to Denise, Resident service director, facility also informs POA or designated family member and reports incidents to Community Care Licensing department.(CCLD).
LPA Singh observed that Resident#1 has not been identified in the complaint submitted to the department on 12/16/2025.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2026
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 2
Control Number 56-AS-20251216091826
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: ATRIA DEL REY
FACILITY NUMBER: 366400985
VISIT DATE: 07/03/2026
NARRATIVE
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Second Allegation:-Facility did not give/seek proper care.
LPA Singh conducted interview with Denise Naulls-Jordan, facility Resident service Director who stated that facility staff ensures that residents are given proper care and supervision and also documented in needs and services logs.

Third Allegation:-Facility charged resident family additional fees for next level care of service with out providing it.
LPA Singh conducted interview with facility Resident Service Director who stated that facility staff follows the policies and procedures when a resident is assessed and level of care is determined keeping in mind change of condition, falls and activities of daily living(ADL's). According to Resident Service Director Denise Naulls-Jordan, Facility maintains complete transparency with the family and Power of Attorney(POA) for the resident. Discussions and meetings are held with the resident's Power of Attorney (POA) and family. The family are fully informed about the changes in the resident's condition and the necessity of upgrading their care. Residents families are in complete agreement with both the increased level of care and the financial adjustments before moving forward with resident's level of care and financial adjustments.

Resident#1 has not been identified in the complaint submitted to the department so these allegations are Unsubstantiated.

Based on the evidence found during the investigation, the allegations listed Resident sustained injuries and was not reported to family, Facility did not give/seek proper care and Facility charged resident family additional fees for next level care of service with out providing it, is deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.

An exit interview was conducted, and this report (LIC9099) was discussed and provided to Denise Naulls-Jordan-Resident Service Director, facility representative.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2