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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 335530125
Report Date: 10/27/2025
Date Signed: 10/27/2025 03:53:13 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
07/24/2025 and conducted by Evaluator Mary Rico
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20250724121333
FACILITY NAME:OHANA EXCELLENCE ASSISTED LIVINGFACILITY NUMBER:
335530125
ADMINISTRATOR:MARC, OANAFACILITY TYPE:
740
ADDRESS:18580 MANITOU STREETTELEPHONE:
(951) 268-6060
CITY:CORONASTATE: CAZIP CODE:
92881
CAPACITY:6CENSUS: 5DATE:
10/27/2025
UNANNOUNCEDTIME BEGAN:
12:41 PM
MET WITH:Administrator- Oana Marc TIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Staff did not adequately supervise resident resulting in a medical condition.
Staff handled resident in a rough manner.
Staff spoke inappropriately to resident.
Staff isolated resident by limiting resident's visitations.
Staff did not seek medical attention for resident.
Staff are not meeting resident's dietary needs.
Staff does not afford the resident privacy.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Administrator Oana Marc and explained the purpose of the visit. The investigation consisted of staff interviews, resident interviews, record review and facility tour.

For the allegation, Staff did not adequately supervise resident resulting in a medical condition. During staff interviews, 3 out of the 3 staff stated that adequate supervision has been provided to residents, and no medical condition has been caused by staff. During resident interviews 3 out of the 4 resident stated adequate supervision is provided. 1 out of the 4 residents was unable to collaborate on the allegation.

For the allegation, Staff handled resident in a rough manner. During staff interviews, 3 out of the 3 staff stated they have not handled a resident in a rough manner. During resident interviews, 3 out of the 4 residents stated they have not been handled in a rough manner by staff. 1 out of the 4 residents was unable to collaborate on the allegation.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025
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-20250724121333
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: OHANA EXCELLENCE ASSISTED LIVING
FACILITY NUMBER: 335530125
VISIT DATE: 10/27/2025
NARRATIVE
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For the allegation, Staff spoke inappropriately to resident. During staff interviews, 3 out of the 3 staff stated they do not speak inappropriately to their residents. During resident interviews 3 out of the 4 residents stated staff do not speak inappropriately to them. 1 out of the 4 residents was unable to collaborate on the allegation.

For the allegation, Staff isolated resident by limiting resident's visitations. During staff interviews, 3 out of the 3 staff stated they allow residents visitors inside the facility and have not isolated a resident. During resident interviews 3 out of the 4 residents stated their visitors are allowed inside the facility. In addition the 3 out 4 residents also stated have not been isolated. 1 out of the 4 residents was unable to collaborate on the allegation.

For the allegation, Staff did not seek medical attention for residents. During staff interviews, 3 out of the 3 staff stated that all residents receive medical attention. During resident’s interviews 3 out of the 4 residents stated they receive medical attention from staff. 1 out of the 4 residents was unable to collaborate on the allegation.

For the allegation, Staff are not meeting resident's dietary needs. During staff interviews 3 out of 3 stated they meet residents’ dietary needs. During residents’ interviews 3 out of the 4 residents stated staff meet their dietary needs. 1 out of the 4 residents was unable to collaborate on the allegation. During facility tour LPA observed variety of food available for residents.

For the allegation, Staff does not afford the resident privacy. During staff interviews 3 out of the 3 staff stated privacy is provided to all residents. During residents’ interviews 3 out of the 4 residents stated privacy is provided. 1 out of the 4 residents was unable to collaborate on the allegation.

Based on the evidence found during the investigation, the (7) 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, and this report (LIC9099) was discussed and provided to Administrator Oana Marc.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2