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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 330905299
Report Date: 04/11/2025
Date Signed: 04/11/2025 12:45:05 PM

Substantiated


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
11/13/2023 and conducted by Evaluator Raquel Hernandez
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20231113111520
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: 28DATE:
04/11/2025
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:House Manager Florence Nahin TIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff are not adequately supervising resident(s) resulting in resident(s) wandering from the facility while in care.
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 and resident interviews

For the allegation, Staff are not adequately supervising resident(s) resulting in resident(s) wandering from the facility while in care.

LPA Hernandez spoke with Administrator Ghislaine Ramasar regarding former resident. Administrator Ghislaine stated former resident did leave the facility without staff knowing. Additionally, former resident was found three hours after they went missing.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2025
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 5
Control Number 56-AS-20231113111520
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: 04/11/2025
NARRATIVE
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Based on observations, interviews, and record review, the allegations are SUBSTANTIATED. A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met.

During today’s visit, a deficiency was cited per Title 22, Division 6, of the California Code of Regulations.

An exit interview was conducted, and this report LIC9099, LIC9099C and LIC9099D were discussed and provided to House Manager Florence Nahin and discussed over the phone with licensee Ghislaine Ramasar and Oscar Ramasar along with a copy of the appeal rights.

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

DATE: 04/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
11/13/2023 and conducted by Evaluator Raquel Hernandez
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20231113111520

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: 28DATE:
04/11/2025
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:House Manager Florence NahinTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff do not ensure a safe environment for resident(s) in care.
Licensee is not ensuring that a complete record is being maintained for a resident in care.
Staff do not seek assistance for resident(s) in care in a timely manner.
Facility is unkempt.
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 and resident interviews

For the allegation, Staff did not ensure a safe environment for resident(s) in care.

LPA Hernandez conducted (6) resident interviews. 6 out of the 6 residents stated they feel safe at facility. Additionally, LPA Hernandez conducted (4) staff interviews. 4 out of the 4 staff stated the facility provides a safe environment for residents in care.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 56-AS-20231113111520
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: 04/11/2025
NARRATIVE
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For the allegation, Licensee is not ensuring that a complete record is being maintained for a resident in care.

LPA Hernandez reviewed and received resident file for former resident. Additionally, LPA Hernandez spoke with Administrator Ghislaine Ramasar who stated residents records are completed and kept in a secure and locked space.

For the allegation, Staff do not seek assistance for resident(s) in care in a timely manner.

LPA Hernandez conducted (6) resident interviews. 5 out of the 6 residents stated facility staff do help them in a timely manner. LPA Hernandez conducted (4) staff interviews. 4 out of the 4 staff stated facility staff do help residents in a timely manner.

For the allegation, Facility is unkept.

LPA Hernandez conducted (6) resident interviews. 6 out of the 6 residents stated the facility is kept clean. Additionally, LPA Hernandez conducted (4) staff interviews. 4 out of the 4 staff stated the facility is cleaned everyday and it is always kept clean.

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 pertaining to these allegations, 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: 04/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 56-AS-20231113111520
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/11/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/14/2025
Section Cited
HSC
1569.312(e)
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1569.312 Basic Service Requirements (e) Monitoring the activities of the residents while they are under the supervision of the facility to ensure their general health, saftey, and well-being.
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Licensee stated to submit proof of staff training on supervision rules to LPA Hernandez by Plan of Correction (POC) due date.
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Based on interviews, licensee failed to meet this requirement by not ensuring staff were properly supervising residents, which poses an immediate health, saftey or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5