<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604135
Report Date: 12/02/2025
Date Signed: 12/02/2025 10:48:48 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE 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
05/12/2023 and conducted by Evaluator Deborah Lee
COMPLAINT CONTROL NUMBER: 18-AS-20230512092612
FACILITY NAME:SHADOWRIDGEFACILITY NUMBER:
374604135
ADMINISTRATOR:BEATRICE BRACAMONTEFACILITY TYPE:
740
ADDRESS:2354 WATSON WAYTELEPHONE:
(760) 295-3888
CITY:VISTASTATE: CAZIP CODE:
92081
CAPACITY:0CENSUS: 0DATE:
12/02/2025
UNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:TIME COMPLETED:
10:36 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Lack of care and supervision
Staff did not answer resident's call button in a timely manner
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 12/2/25 Licensing Program Analyst (LPA) Deborah Lee conducted a follow-up investigation to determine findings of the above-mentioned allegations.

The investigation consisted of the following:
On 05/19/23 Licensing Program Analyst (LPA) Janira Arreola conducted an initial visit to facility to investigate allegations listed above. During the visit, the LPA conducted interviews, documented observations, and conducted records reviews. At time of visit, it was determined that further investigation is needed before determining the findings.

On 11/26/25, Licensing Program Analyst (LPA) Deborah Lee conducted a follow-up investigation and attempted to contact the reporting party for an interview. However, the LPA was unable to interview the reporting party.
Page 1 of 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
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 18-AS-20230512092612
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: SHADOWRIDGE
FACILITY NUMBER: 374604135
VISIT DATE: 12/02/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Allegation: Lack of care and supervision

The detail of the complaint alleges that on 5/4/23 a resident called 911 for a lift assist, because staff did not respond to resident’s call for help.

At the time of investigation follow-up, there were no available records to review or interviews of staff and residents for this complaint. There is insufficient evidence to support the allegation mentioned above; 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.

Allegation: Staff did not answer resident's call button in a timely manner

The detail of complaint alleges that on 5/10/22 a resident called staff using call button and staff did not respond.

At the time of investigation follow-up, there are no available records to review or interviews for this complaint. There is insufficient evidence to support the allegation mentioned above; 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.

This facility closed 4/7/2025

A copy of this report will be mailed to last known address: 2354 Watson Way Vista CA 92081

page 2 of 2

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2