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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 330905299
Report Date: 12/26/2024
Date Signed: 12/26/2024 03:22:34 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
12/20/2024 and conducted by Evaluator Raquel Hernandez
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20241220111135
FACILITY NAME:CREST HOME FOR THE ELDERLYFACILITY NUMBER:
330905299
ADMINISTRATOR:RAMASAR, OSCARFACILITY TYPE:
740
ADDRESS:4460 CREST VIEW DRIVETELEPHONE:
(951) 736-2921
CITY:NORCOSTATE: CAZIP CODE:
92860
CAPACITY:29CENSUS: 29DATE:
12/26/2024
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:House Manager Florence Nahin TIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Facility staff is forcing residents to take medications.
Facility staff is opening resident's mail without permission.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Raquel Hernandez conducted an unnannounced visit for the purpose to deliver findings on the allegation listed above. LPA met with House Manager Florence Nahin and explained the purpose of the visit. The investigation consisted of staff interviews, resident interviews and facility tour.

For the allegation, Facility staff is forcing residents to take medications.

LPA Hernandez conducted (6) resident interviews. (4) out of the (6) residents stated staff does not force them to take their medications and have not witnessed any staff forcing other residents to take their medication. (2) out of the (6) staff stated staff does force them to take their medications. LPA Hernandez conducted (4) staff interviews. (4) out of the (4) staff stated they do not force residents to take their medications and have not witnessed any staff forcing residents to take their medications.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2024
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-20241220111135
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: CREST HOME FOR THE ELDERLY
FACILITY NUMBER: 330905299
VISIT DATE: 12/26/2024
NARRATIVE
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For the allegation, Facility staff is opening resident's mail without permission.

LPA Hernandez conducted (6) resident interviews. (6) out of the (6) residents stated staff does not open their mail without their permission. LPA Hernandez conducted (4) staff interviews. (4) out of the (4) staff stated they do not open resident's mail without their permission and have not witnessed any staff opening resident's mail without their permission.

Based on the evidence gathered during today’s investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC9099) was discussed and provided to House Manager Florence Nahin.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2