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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366402583
Report Date: 05/19/2026
Date Signed: 05/19/2026 01:34:10 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
01/16/2026 and conducted by Evaluator Raquel Hernandez
COMPLAINT CONTROL NUMBER: 56-AS-20260116151011
FACILITY NAME:BROOKDALE NORTH EUCLIDFACILITY NUMBER:
366402583
ADMINISTRATOR:LISA TOFACILITY TYPE:
740
ADDRESS:1031 N EUCLID AVETELEPHONE:
(909) 391-2622
CITY:ONTARIOSTATE: CAZIP CODE:
91762
CAPACITY:140CENSUS: DATE:
05/19/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Business Office Manager Marcos RamosTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Licensee financially abused resident as a form of retaliation
Staff do not ensure resident receives assistance with personal and dental hygiene care needs
Staff did not ensure residents call button was made accessible for use
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Raquel Hernandez conducted an unannounced visit for the purpose of deliver findings for the above allegations. LPA met with Business Office Manager Marcos Ramos and explained today's visit.

LPA spoke with Administer Logan Harrison who stated no financial abuse due to retaliation was formed against Resident #1 (R1). Administrator stated all payments being issued were in regards to R1's care plan. Additionally, LPA observed and reviewed documentation showing invoice that was being charged to R1 that included all R1's service fees and no additional amounts. LPA conducted (8) resident interviews. 7 out of the 8 stated the facility does offer assistance with dental and hygiene needs when requested. LPA conducted (6) staff interviews. 6 out of the 6 staff stated there is transportation given to residents and assistance with dental and hygiene needs. Additionally, LPA conducted (8) resident interviews. 7 out of the 8 stated their call button is made accessible for use. LPA conducted (6) staff interviews. 6 out of the 6 staff stated call buttons are kept with residents and made accessible at all times.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2026
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-20260116151011
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: BROOKDALE NORTH EUCLID
FACILITY NUMBER: 366402583
VISIT DATE: 05/19/2026
NARRATIVE
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Based on the evidence gathered during today’s investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

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) (LIC9099C) was discussed and provided to Business Office Manager Marcos Ramos.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2026
LIC9099 (FAS) - (06/04)
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