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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366411359
Report Date: 08/29/2025
Date Signed: 08/29/2025 09:57:17 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
08/06/2025 and conducted by Evaluator Raquel Hernandez
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20250806095729
FACILITY NAME:GALA HOMEFACILITY NUMBER:
366411359
ADMINISTRATOR:JONATHAN SAMONTEFACILITY TYPE:
735
ADDRESS:10986 GALA LANETELEPHONE:
(909) 902-9108
CITY:ONTARIOSTATE: CAZIP CODE:
91762
CAPACITY:6CENSUS: 6DATE:
08/29/2025
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Administrator Lilian TolentinoTIME COMPLETED:
10:10 AM
ALLEGATION(S):
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Staff is physically abusing residents causing injuries.
Staff is verbally abusing residents.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Raquel Hernandez conducted an unannounced visit to deliver findings on the allegation listed above. LPA met with Administrator Lilian Tolentino and explained the purpose of the visit. The investigation consisted of staff interviews and request of documentation.

For the allegation, Staff is physically abusing residents causing injuries.

LPA conducted (8) staff interviews. 8 out of the 8 stated they have not witnessed any facility staff physically abusing the clients in care. Additionally, LPA received body checks for all clients in care.

For the allegation, Staff is verbally abusing residents in care.

LPA conducted (8) staff interviews. 8 out of the 8 stated they have not witnessed any facility staff verbally abusing the clients in care. LPA observed clients in care are all non-verbal.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025
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 56-AS-20250806095729
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: GALA HOME
FACILITY NUMBER: 366411359
VISIT DATE: 08/29/2025
NARRATIVE
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Based on the evidence gathered during today’s investigation, the allegation listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted and a copy of this report (LIC9099) was discussed and provided to Administrator Lilian Tolentino.

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

DATE: 08/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2