366405765-5-4-2026-56-AS-NBRN-DUFTJ6-20260526144550

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 366405765
Report Date: 05/04/2026
Date Signed: 05/04/2026 03:13:11 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
09/29/2025 and conducted by Evaluator Becky Mann

COMPLAINT CONTROL NUMBER: 56-AS-20250929154635

FACILITY NAME:	CASA COLINA CENTERS FOR REHABILITATION/PADUA VILLA		FACILITY NUMBER:	366405765
ADMINISTRATOR:	STEPHANIE E. KAPLAN		FACILITY TYPE:	735
ADDRESS:	22200 HIGHWAY 18		TELEPHONE:	(760) 247-7711
CITY:	APPLE VALLEY	STATE: CA	ZIP CODE:	92307
CAPACITY:	54	CENSUS: 30	DATE:	05/04/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	J. Rosa Tucker, Program Director		TIME COMPLETED:	03:25 PM

ALLEGATION(S):

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Staff did not dispense medications to client as prescribed, resulting in hospitalization
Staff are not keeping accurate client records

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Becky Mann conducted an unannounced visit to the facility to initiate a complaint investigation. LPA met with J. Rosa Tucker, Program Director, and explained the purpose of the visit. The investigation consisted of LPA pertinent record reviews, observations and interviews with staff and clients.

On 09/29/2025, the Department received a complaint with the allegation of Neglect/Lack of Care and Supervision – Staff did not dispense medications to client as prescribed, resulting in hospitalization. The Department investigation consisted of review of facility and medical records, observations, and interviews with pertinent individuals.
It was reported that Client #1 (C1), was hospitalized in the Intensive Care Unit (ICU) due to C1 not receiving their seizure medication. Although C1 was hospitalized following a seizure, interviews with facility staff, C1’s doctor, and a review of medical records indicated that the seizure was not caused by a missed medication dose.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Becky Mann
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 56-AS-20250929154635

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: CASA COLINA CENTERS FOR REHABILITATION/PADUA VILLA	FACILITY NUMBER: 366405765
	VISIT DATE: 05/04/2026

NARRATIVE

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C1’s doctor confirmed that C1’s medications were long-acting and a short delay in administration would not trigger a seizure. Medication administration records were reviewed, and no pattern of missed doses were observed. Interviews reveal that staff followed emergency protocols by contacting 911 and arranging transfer for higher-level care. Interviews with clients did not reveal concerns about missed medication doses or staff mishandling their medication. There is insufficient evidence to prove that due to Neglect/Lack of Care and Supervision, C1’s missed medication dose led to their hospitalization in the ICU, therefore the allegation is Unsubstantiated.

The allegation that Staff are not keeping accurate client records. LPA reviewed three (3) client medications, based on LPA observations and record reviews, medications are being administered as prescribed by a physician. Medications matched the Medication Administration Record (MAR). LPA did not observe any missed medication dose during medication audit.

Based on evidence obtained during this investigation, the allegations above are 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 was discussed and a copy of this report was provided to J. Rosa Tucker, Program Director, at the conclusion of the visit.

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Becky Mann
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2026

LIC9099 (FAS) - (06/04)

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