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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366413072
Report Date: 12/20/2023
Date Signed: 12/20/2023 10:20:12 AM

Unfounded


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
12/18/2023 and conducted by Evaluator Anna Bueno
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20231218140216
FACILITY NAME:VILLAS AT SAN BERNARDINOFACILITY NUMBER:
366413072
ADMINISTRATOR:YVETTE NAVARROFACILITY TYPE:
740
ADDRESS:2985 NORTH G STREETTELEPHONE:
(909) 883-7703
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92405
CAPACITY:97CENSUS: DATE:
12/20/2023
UNANNOUNCEDTIME BEGAN:
09:14 AM
MET WITH:Kenya Carlton - Executive DirectorTIME COMPLETED:
10:22 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is trying to illegally evict resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced visit to this facility for the purpose of initiating the investigation of and delivering findings for the above allegations. LPA met with executive director Kenya Carlton and was advised of the purpose of visit. The investigation consisted of records review and interviews with relevant parties.

The allegation is Facility is trying to illegally evict Resident (R1). LPA reviewed records and found that the notice provided to R1 is a late rent notice. LPA reviewed R1's tenant ledger and found that R1 is paid to date for their portion of the housing share of cost. LPA found that the facility has not received payment from R1's service provider since October 2023.

Based on the available information, we have found the complaint allegation is UNFOUNDED. A finding of unfounded means that the allegations were false, could not have happened and/or is without a reasonable basis. An exit interview was conducted where this report was discussed with and provided to Administrator Carlton.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Anna BuenoTELEPHONE: 951-204-4307
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
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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