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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 335530171
Report Date: 11/05/2025
Date Signed: 11/05/2025 01:45:50 PM

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
10/30/2025 and conducted by Evaluator Hannah Rodgers
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20251030143729
FACILITY NAME:WILDOMAR SENIOR ASSISTED LIVINGFACILITY NUMBER:
335530171
ADMINISTRATOR:KAREN ROPERFACILITY TYPE:
740
ADDRESS:32365 SOUTH PASADENA STTELEPHONE:
(323) 902-6000
CITY:WILDOMARSTATE: CAZIP CODE:
92595
CAPACITY:200CENSUS: 111DATE:
11/05/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Executive Director Karen Roper and Assistant Executive Director Theresa Gamez TIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Licensee overcharged resident.
Staff did not ensure that residents were accorded privacy.

INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced visit to deliver findings regarding the above complaint allegations. LPA introduced herself and disclosed the purpose of the visit to Executive Director Karen Roper and Assistant Executive Director Theresa Gamez.

On October 30, 2025, it was alleged that the licensee overcharged resident, and staff did not ensure that residents were accorded privacy. The Department’s investigation consisted of an unannounced facility visit, records review, and staff and resident interviews.

According to the allegations received, Resident #1 (R1) has been overcharged by the facility for the last seven months. It was also alleged that staff members have entered R1’s and Resident #2 (R2)’s bedroom without permission.

[CONTINUED ON LIC9099-C]
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Hannah Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
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-20251030143729
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: WILDOMAR SENIOR ASSISTED LIVING
FACILITY NUMBER: 335530171
VISIT DATE: 11/05/2025
NARRATIVE
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Review of R1’s facility admission records revealed that R1 was admitted to the facility on June 18, 2024, with the Assisted Living Waiver (ALW) program. Interviews and records reviewed did not reveal that R1 was overcharged for the last seven months. Review of R1’s monthly invoice did not reveal that R1 was overcharged. Also, interviews provided inconsistent information and did not reveal that staff enter resident’s bedrooms inappropriately.

Based on interviews and record review, the investigation did not yield a preponderance of evidence to conclude that the licensee overcharged resident, and staff did not ensure that residents were accorded privacy. Based on the foregoing, the allegations are unsubstantiated. This finding means that although the allegation may have happened or may be valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted with Executive Director Karen Roper and Assistant Executive Director Theresa Gamez, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Hannah Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2