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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366413179
Report Date: 09/17/2025
Date Signed: 09/17/2025 02:49:40 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
08/25/2025 and conducted by Evaluator Eldin Serrano
COMPLAINT CONTROL NUMBER: 56-AS-20250825145742
FACILITY NAME:ALYZA HOMEFACILITY NUMBER:
366413179
ADMINISTRATOR:FRANCIS PASTORFIDEFACILITY TYPE:
735
ADDRESS:5062 RODEO STREETTELEPHONE:
(909) 270-3738
CITY:MONTCLAIRSTATE: CAZIP CODE:
91763
CAPACITY:6CENSUS: 5DATE:
09/17/2025
UNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Aizabel Tolentino, AdministratorTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
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9
Personal Rights
INVESTIGATION FINDINGS:
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13
On 9/17/2025 at 2:05 PM, Licensing Program Analyst (LPA) Eldin Serrano made an unannounced visit to the facility to investigate and deliver the findings of the above allegations. LPA Serrano met with the administrator Aizabel Tolentino to explain the purpose of the visit. The investigation consisted of file review, interviews with facility staff as well as facility observation.

For the allegation, Personal Rights – Based on staff interviews, it was revealed that 7 out 9 staff stated that they have not witnessed staff #10 (S10) yelled and used a ruler like stick to scare the clients. LPA observed clients in care are non-verbal. The information received during the investigation did not corroborate with the allegation.

*** Continuation in LIC9099C ***

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Eldin Serrano
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2025
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-20250825145742
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: ALYZA HOME
FACILITY NUMBER: 366413179
VISIT DATE: 09/17/2025
NARRATIVE
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During the investigation, LPA did not find evidence to corroborate the allegations.

Based on the evidence, the allegation mentioned above is UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means 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, therefore the allegation is unsubstantiated at this time.

An exit interview was conducted where this report, LIC9099 and LIC 9099C were discussed and provided to administrator Aizabel Tolentino.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Eldin Serrano
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2