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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366405765
Report Date: 11/02/2022
Date Signed: 11/02/2022 02:34:05 PM

Unsubstantiated


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
08/17/2021 and conducted by Evaluator Natalie Ibarra
COMPLAINT CONTROL NUMBER: 18-AS-20210817081210
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:
11/02/2022
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Rodney PeekTIME COMPLETED:
02:55 PM
ALLEGATION(S):
1
2
3
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5
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7
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9
Facility does not provide a safe environment for residents.
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Natalie Gayoso Ibarra and Paola Guerrero conducted an unannounced visit to the facility to deliver findings. LPA met with administrator Rodney Peek and explained the purpose of today’s visit. The investigation consisted of interviews with pertinent parties.

The allegation indicates facility does not provide a safe environment for residents. Interviews with Client #1 (C1), Client #2 (2), Client #3 (C3), Client #4 (C4), Client #5 (C5), Client #6 (C6), and Client #7 (C7) have stated they have never witnessed staff verbally and/or physically abuse clients in care. Interviews with Staff #2 (S2), Staff #3 (S3), Staff #4 (S4), Staff #6 (S6), and Staff #7 (S7) stated they have never witness staff being verbally and/or physically abuse to the clients.

Based on the information obtained, the allegations are UNSUBSTANTIATED. A finding of UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Natalie Ibarra
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
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-20210817081210
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: CASA COLINA CENTERS FOR REHABILITATION/PADUA VILLA
FACILITY NUMBER: 366405765
VISIT DATE: 11/02/2022
NARRATIVE
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No deficiencies were cited during this visit.
An exit interview was conducted, and a copy of this report was provided to the Administrator
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Natalie Ibarra
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2