335530125-1-7-2026-56-AS-EMAN-DTLV7U-20260429161143

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 335530125
Report Date: 01/07/2026
Date Signed: 01/07/2026 12:23:47 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
12/01/2025 and conducted by Evaluator Mary Rico

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20251201154307

FACILITY NAME:	OHANA EXCELLENCE ASSISTED LIVING		FACILITY NUMBER:	335530125
ADMINISTRATOR:	MARC, OANA		FACILITY TYPE:	740
ADDRESS:	18580 MANITOU STREET		TELEPHONE:	(951) 268-6060
CITY:	CORONA	STATE: CA	ZIP CODE:	92881
CAPACITY:	6	CENSUS: 6	DATE:	01/07/2026
		UNANNOUNCED	TIME BEGAN:	09:11 AM
MET WITH:	Administrator Ohana Marc		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Due to staff not having required hoyer training, residents were injured.
Staff handled resident roughly.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to investigate and deliver findings on the allegations listed above. LPA met with Administrator Ohana Marc and explained the purpose of the visit. The investigation consisted of staff interviews, resident interviews, and record review.

For the allegation, Due to staff not having required hoyer training, residents were injured. During staff interviews, 3 out of the 3 staff stated no resident had been injury during a hoyer lift transfer. In addition, 3 out of the 3 staff stated hoyer lift training had been provided. During record review, LPA observed hoyer lift training had been provided to staff.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:	DATE: 01/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2026

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-20251201154307

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: 01/07/2026

NARRATIVE

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For the allegation, Staff handled resident roughly. During staff interviews 3 out of the 3 staff stated they had not handled a resident in a rough manner. During resident interviews, 5 out of the 6 residents were unable to collaborate on the allegation. In addition, 1 out of the 6 residents stated they were not handled in a rough manner.

Based on the evidence found during the investigation, the (2) 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 Ohana Marc.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:	DATE: 01/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2026

LIC9099 (FAS) - (06/04)

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