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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881251
Report Date: 03/19/2026
Date Signed: 03/19/2026 10:39:08 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
07/09/2025 and conducted by Evaluator Beena Singh
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20250709093102
FACILITY NAME:WESTHILLS VILLA GARDENSFACILITY NUMBER:
331881251
ADMINISTRATOR:THELMA MONTEBONFACILITY TYPE:
740
ADDRESS:5466 WEST WILSON ST.TELEPHONE:
(951) 849-7521
CITY:BANNINGSTATE: CAZIP CODE:
92220
CAPACITY:30CENSUS: 18DATE:
03/19/2026
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Facility Administrator-Thelma MontebonTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Licensee is not providing resident's records to their representative as necessary.
INVESTIGATION FINDINGS:
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On 3/19/2026, at 8:50 AM, Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to the facility to deliver findings for a complaint investigation. LPA Singh met with a staff,greeted and granted entry to the facility. Facility Administrator, Thelma Montebon, was informed, arrived during the visit and LPA Singh explained the purpose of the visit to the facility administrator.

Allegation:Licensee is not providing resident's records to their representative as necessary.

During the investigation, Licensing Program Analyst (LPA) Singh reviewed Statements, records, and interviews obtained did not provide sufficient information to corroborate the allegation.LPA Singh determined after reviewing all the records,interview with the licensee and staff that there was insufficient evidence to corroborate the allegation that the licensee failed to provide resident records to an authorized representative.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
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-20250709093102
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: WESTHILLS VILLA GARDENS
FACILITY NUMBER: 331881251
VISIT DATE: 03/19/2026
NARRATIVE
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The review revealed that Resident #1 (R#1) is under the legal authority of a public guardian/conservator who makes decisions on R#1's behalf. The facility successfully maintained communication with this conservator regarding R#1’s change in condition, including R#1's subsequent transfer to a hospital and a skilled nursing facility for a higher level of care. Furthermore, when R#1’s family requested records, the licensee provided the documentation to the family's legal counsel under the specific direction of the public guardian/conservator of Resident#1.

Based on the evidence found during the investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.


An exit interview was conducted where this report LIC9099 was discussed,signed and a copy provided to Facility Administrator Thelma Montebon at the conclusion of the visit.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2