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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881248
Report Date: 10/23/2025
Date Signed: 10/23/2025 01:28:29 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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
03/26/2024 and conducted by Evaluator Magda Malcore
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240326152021
FACILITY NAME:WESTFIELD VILLA GARDENSFACILITY NUMBER:
331881248
ADMINISTRATOR:MARIA JASMIN DOLORESFACILITY TYPE:
740
ADDRESS:3863 WEST RAMSEY STTELEPHONE:
(951) 849-7521
CITY:BANNINGSTATE: CAZIP CODE:
92220
CAPACITY:50CENSUS: 39DATE:
10/23/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Alma EspinalTIME COMPLETED:
01:25 PM
ALLEGATION(S):
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Licensee is not adhering to proper eviction protocols with residents in care
Staff are not reporting incidents involving residents in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced visit to the facility to conduct complaint investigation on the above allegations. LPA met with Administrator, Alma Espinal who was informed of today’s visit. The investigation consisted of LPA observations, reviewing pertinent records, and interviews with relevant parties.

Regarding the allegation, Licensee is not adhering to proper eviction protocols with residents in care, it was alleged that Resident #1 (R1), Resident #2 (R2), and Resident #3 (R3) were not provided relocation assistance after being served eviction. A review of facility records reveals that R1 and R2 were issued 30-day eviction notices, which included a referral list for residential care housing. Interviews with staff and a review of records revealed that R3 was not given an eviction notice, as R3’s family voluntarily discharged the resident from the facility. Therefore, there is not enough evidence to corroborate the allegation.
**continued on LIC9099C**
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
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-20240326152021
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: WESTFIELD VILLA GARDENS
FACILITY NUMBER: 331881248
VISIT DATE: 10/23/2025
NARRATIVE
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Regarding the allegation, staff are not reporting incidents involving residents in care, It was alleged that staff did not report a fall incident involving Resident #3 (R3) to R3’s authorized representative in a timely manner. Review of facility records reveals that on March 7, 2024, R3 sustained a fall at the facility. Interviews with staff reveal that R3’s authorized representative was informed of the fall on the same day. Additionally, an incident report was submitted by facility staff to the Community Care Licensing Division (CCLD) regional office on March 7, 2024. Therefore, there is not enough evidence to corroborate the allegation.

Based the Department's investigation, the allegations are Unsubstantiated. Unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted, during which this report was discussed, and a copy with appeal rights was provided to Administrator Espinal at the conclusion of the visit
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2