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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366405765
Report Date: 07/09/2025
Date Signed: 07/09/2025 02:21:46 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/10/2021 and conducted by Evaluator Javier Prieto
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20211210133012
FACILITY NAME:CASA COLINA CENTERS FOR REHABILITATION/PADUA VILLAFACILITY NUMBER:
366405765
ADMINISTRATOR:RODNEY PEEKFACILITY TYPE:
735
ADDRESS:22200 HIGHWAY 18TELEPHONE:
(760) 247-7711
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92307
CAPACITY:54CENSUS: 34DATE:
07/09/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Candis Haslacker, Resident ManagerTIME COMPLETED:
02:25 PM
ALLEGATION(S):
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Residents are not provided adequate supervision.

Resident was locked out of the facility

Residents not provided a safe environment
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to concluded a complaint investigation regarding the above allegations. LPA Prieto met with Candis Haslacker and explained the elements of the complaint.

Allegation #1 - LPA Prieto interviewed staff #1 (S1), S2, S3 and S4, all who stated that there is sufficient staff to care for residents in care. Resident Manager Haslacker, states the facility will employ 14 to 15 staff per shift for a census of 34 residents. Resident #1 (R1), was interviewed and states staff will assist with outings and medication administration. R1 also states cameras are located on outside parameters to know resident whereabouts. R2 interviewed states staff has knowledge of his whereabouts and has a sign in/out policy.

Allegation #2 - LPA interviewed R1 who state that residents are allowed to leave the facility as long as they follow a sign in/out policy. R1 added that all residents know that code that opens the gates to the facility.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2025
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 18-AS-20211210133012
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME: CASA COLINA CENTERS FOR REHABILITATION/PADUA VILLA
FACILITY NUMBER: 366405765
VISIT DATE: 07/09/2025
NARRATIVE
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Allegation #3 - LPA toured facility and observed it to be clean and free from odors and any dangerous items. The facility has a cinder block parameter with a gate that has a code. The public have to addressed when entering the facility and the facility if located away from the main street away and from traffic. The facility has a community garden that residents can participate in. LPA interview R1, R2 and R3 all who state that facility has adequate supervision, have access to the facility and are provided a safe environment.

Based on the information obtained there is not enough evidence to support the allegations made in this complaint. Therefore, the allegations are deemed UNSUBSTANTIATED at this time. This report was signed by LPA Prieto and Resident Manager Haslacker and a copy was left at the facility.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2