331880726-1-26-2026-56-AS-EMAN-DRENJQ-20260218093043

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880726
Report Date: 01/26/2026
Date Signed: 01/26/2026 11:12:53 AM

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
10/07/2025 and conducted by Evaluator Beena Singh

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20251007111308

FACILITY NAME:	BLISS HOMES		FACILITY NUMBER:	331880726
ADMINISTRATOR:	BHAMBHANI, BHAVNA		FACILITY TYPE:	740
ADDRESS:	6149 COOPERS HAWK DRIVE		TELEPHONE:	(714) 224-6763
CITY:	JURUPA VALLEY	STATE: CA	ZIP CODE:	91752
CAPACITY:	6	CENSUS: 1	DATE:	01/26/2026
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Licensee Ashish Bhambani & Administrator Bhavna Bhambani		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff yells at resident.
Staff throws things at resident.
Staff did not ensure resident's oxygen was plugged in/working properly.
Staff denied access to paramedics.

INVESTIGATION FINDINGS:

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On 1/25/2026, Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to the facility to deliver findings on complaints alleging neglect/lack of supervision. LPA Singh met with staff Rosie,and was granted entry into the facility. Licensee Ashish Bhambani & Administrator Bhavna Bhambani were contacted and arrived during the visit.The investigation conducted by LPA Singh consisted of interviews and reviews of pertinent records.

Allegation: - Staff yells at resident.

Three(3) out of three(3) Staff denied the allegation that Staff yells at residents. All three staff members interviewed denied witnessing staff member S1 throwing items at a resident, stating such behavior never happens and that staff consistently provides good care, with one specifically noting residents are well-looked-after and always ready to assist, always kind to them.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 56-AS-20251007111308

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: BLISS HOMES	FACILITY NUMBER: 331880726
	VISIT DATE: 01/26/2026

NARRATIVE

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Second Allegation:-Staff throws things at resident.

Three (3) out of three(3) facility staff members interviewed stated they did not witness S1 throwing things at resident. Three (3) out of three(3) facility staff members interviewed stated staff would never throws things at the resident, it never happened and staff ensures residents are well looked after. R#2 stated Staff looks after the residents well and always ready to assist them whenever they needed and always kind to them.

Third Allegation:-Staff did not ensure resident's oxygen was plugged in/working properly

Three (3) out of three(3) facility staff members interviewed stated R#1 was on oxygen as needed and would use it as needed. Based on interviews with three facility staff members and a review of admission records by LPA Singh, it was established that Resident #1, was prescribed oxygen on an as needed basis.

According to staff members S1 and S2, paramedics who assessed R#1 noted that while their nasal cannula was in place and Staff indicated they would turn on the portable oxygen tank—which requires manual activation—only when needed. During this time, R#1’s oxygen saturation (SpO2) levels were reported in the high 80s to low 90s. Following the assessment, R#1 declined transport to the emergency room and signed an Against Medical Advice (AMA) form.

Fourth Allegation:-Staff denied access to paramedics.

Three (3) out of three(3) facility staff members interviewed stated Staff always responds to paramedics and assist residents if they need any help.

Based on interviews with three facility staff members, it was indicated that staff consistently respond to paramedics and assist residents as needed. The staff reported that Resident #1 (R#1) refused transport to the hospital. It was further reported that Staff#1 initially told Paramedics that no one called them, as they were unaware that R#1 had called 911, but allowed them entry once the situation was understood.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 56-AS-20251007111308

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: BLISS HOMES	FACILITY NUMBER: 331880726
	VISIT DATE: 01/26/2026

NARRATIVE

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The investigation did not provide any evidence or witnesses that indicated these interactions took place or that there was any neglect/lack of supervision by the facility staff. There is insufficient evidence to prove that Staff yells at resident, Staff throws things at resident, Staff did not ensure resident's oxygen was plugged in/working properly, Staff denied access to paramedics, thus, the allegations are Unsubstantiated

Therefore, based on the evidence gathered during the investigation, the allegations listed above is deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted, and this report (LIC809) LIC 809C were discussed and provided to Licensee Ashish Bhambani .

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2026

LIC9099 (FAS) - (06/04)

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