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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880723
Report Date: 04/08/2025
Date Signed: 04/08/2025 11:08:19 AM

Unfounded


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
04/02/2025 and conducted by Evaluator Becky Mann
COMPLAINT CONTROL NUMBER: 56-AS-20250402104413
FACILITY NAME:ATIENZA RESIDENTIAL CAREFACILITY NUMBER:
331880723
ADMINISTRATOR:ARMSTRONG, CAROLINEFACILITY TYPE:
740
ADDRESS:1328 GALAXY DRTELEPHONE:
(909) 792-3835
CITY:BEAUMONTSTATE: CAZIP CODE:
92223
CAPACITY:6CENSUS: 0DATE:
04/08/2025
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Caroline Armstrong, AdministratorTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Staff did not allow ombudsman representative access to the facility
Staff did not ensure facility phone was answered
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Becky Mann conducted an unannounced visit to the facility to initiate a complaint investigation. LPA Mann met with Caroline Armstrong, Administrator and explained the purpose of today's visit. The investigation consisted of LPA observations, pertinent document reviews, and interviews with staff.

The allegations that staff did not allow ombudsman representative access to the facility and that staff did not ensure facility phone was answered. Caroline, Administrator stated that there was no one at the facility to open the door. There are currently no residents at the facility. The phone number listed on the facility profile is not the correct number. LPA Mann toured the facility with the Administrator Caroline, based on LPA observations there are currently no residents at the facility.

LPA informed Administrator that CCL will conduct an in-office meeting at the Regional Office for previous deficiencies.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Becky Mann
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2025
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-20250402104413
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: ATIENZA RESIDENTIAL CARE
FACILITY NUMBER: 331880723
VISIT DATE: 04/08/2025
NARRATIVE
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Based on evidence obtained during this investigation, the allegation is Unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted where this report was discussed and a copy of this report was provided to Caroline Armstrong, Administrator at the conclusion of the visit.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Becky Mann
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2