366413072-12-20-2023-56-AS-NBRN-CYXQ74-20231228105432

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 BERNARDINO		FACILITY NUMBER:	366413072
ADMINISTRATOR:	YVETTE NAVARRO		FACILITY TYPE:	740
ADDRESS:	2985 NORTH G STREET		TELEPHONE:	(909) 883-7703
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92405
CAPACITY:	97	CENSUS:	DATE:	12/20/2023
		UNANNOUNCED	TIME BEGAN:	09:14 AM
MET WITH:	Kenya Carlton - Executive Director		TIME COMPLETED:	10:22 AM

ALLEGATION(S):

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Facility is trying to illegally evict resident

INVESTIGATION FINDINGS:

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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 Brown	TELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Anna Bueno	TELEPHONE: 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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