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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366427383
Report Date: 07/16/2025
Date Signed: 07/16/2025 01:28:02 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
07/09/2025 and conducted by Evaluator Lavette Farlow
COMPLAINT CONTROL NUMBER: 56-AS-20250709154441
FACILITY NAME:ESPINOZA ADULT CARE HOME IFACILITY NUMBER:
366427383
ADMINISTRATOR:LYDIA ESCUTIAFACILITY TYPE:
735
ADDRESS:14232 SAVANA STREETTELEPHONE:
(909) 770-3544
CITY:ADELANTOSTATE: CAZIP CODE:
92301
CAPACITY:5CENSUS: 4DATE:
07/16/2025
UNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Justin Medina, House Manager, and Lydia Escutia, Administrator TIME COMPLETED:
01:33 PM
ALLEGATION(S):
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Facility staff are mistreating clients in care.
Facility is not providing adequate amount of food to client in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) LaVette Farlow conducted an unannounced visit to the facility to investigation a complaint of the of above mentioned allegations. LPA met with house manager Justin Medina who provided a tour of facility. Justin informed the Licensee Amber Espinoza and Administrator Lydia Escutia of my arrival. Later during my visit the administrator Lydia arrived. The investigation consisted of interviews with staff, observation of staff interaction with clients, and review of records.

Allegation 1: Facility staff are mistreating clients in care. Based on LPA's interviews and observation during the LPA facility tour staff appear to be treating clients with dignity and respect. LPA Farlow interviewed 6 out of 6 staff and observed staff interacting with clients one on one and providing care for clients. LPA Interviews with 6 out of 6 staff revealed that staff have not observed other staff neither have they themselves mistreated clients in care. Staff explained that the non-verbal clients will point to explain their problems or pain areas, laugh, or become aggressive if they are not comfortable with someone or something.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2025
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-20250709154441
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: ESPINOZA ADULT CARE HOME I
FACILITY NUMBER: 366427383
VISIT DATE: 07/16/2025
NARRATIVE
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 LPA observed staff encouraging clients to participate in activities, supervising clients outside and ensuring that they are properly hydrated. Although, clients were non-verbal they appear to be comfortable with staff.
Based on the findings the allegation is UNSUBSTANTIATED.

Allegation 2: Facility is not providing adequate amount of food to client in care. LPA interviewed 6 out of 6 staff. The interview revealed that 6 out of 6 staff stated that the facility always has a sufficient amount of food for the number of clients in care. The staff stated they shop twice weekly, and we label our food. We are never short or experience any shortage or molded items. LPA observation during the tour there was adequate food supply in the refrigerator, deep freezer, pantry, and extra storage for the clients in care for 7 days of nonperishable and 2 days of perishable items. Also, the facility maintains a weekly meal plan that was current and posted on the refrigerator. Based on the findings the allegation is UNSUBSTANTIATED.

Based on the information above, the allegations is unsubstantiated. A finding of UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted where this report LIC 9099, and LIC 9099C were discussed and a copy was provided to the Administrator Lydia Escutia and House Manger Bessie Ozenbaugh.

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2025
LIC9099 (FAS) - (06/04)
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