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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 330905299
Report Date: 07/17/2025
Date Signed: 07/17/2025 01:56:26 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
07/25/2024 and conducted by Evaluator Raquel Hernandez
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240725085934
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:
07/17/2025
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Administrator Janette RacelisTIME COMPLETED:
02:10 PM
ALLEGATION(S):
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Staffs do not ensure residents medications are secured and locked.
Staff do not ensure that residents are taking medication as prescribed.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Raquel Hernandez conducted an unnannounced visit for the purpose to deliver findings on the allegations listed above. LPA met with Administrator Janette Racelis and explained the purpose of the visit. The investigation consisted of staff interviews, facility tour, and resident interviews.

For the allegation, Staffs do not ensure residents medications are secured and locked.

LPA Hernandez observed medication room to be locked and secured. LPA Hernandez spoke with Staff #2 (S2) who stated residents are asked to come to medication room and facility staff will pass out resident’s medications accordingly. LPA conducted (4) resident interviews. 4 out of the 4 residents indicated medication room is kept secured and locked at all times.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025
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-20240725085934
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: 07/17/2025
NARRATIVE
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For the allegation, Staffs do not ensure that residents are taking medications as prescribed.

LPA Hernandez conducted (4) resident interviews. 4 out of the 4 residents stated facility staff ensure their medications are taken as prescribed. LPA conducted (2) staff interviews. 2 out of the 2 facility staff stated all resident’s medications are taken as prescribed, however, if a resident declines it is then documented as a medication refusal.

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 Administrator Janette Racelis.

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

DATE: 07/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2