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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 335530171
Report Date: 01/14/2026
Date Signed: 01/14/2026 03:47:20 PM

Substantiated


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
12/02/2025 and conducted by Evaluator Hannah Rodgers
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20251202132657
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: 109DATE:
01/14/2026
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Executive Director Karen RoperTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff did not allow resident to use assistive devices
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced visit to deliver findings regarding the above complaint allegation. LPA introduced herself and disclosed the purpose of the visit to Executive Director Karen Roper.

On December 2, 2025, it was alleged that staff did not allow resident to use assistive devices. The Department’s investigation consisted of an unannounced facility visit, records review, and staff, resident, and outside source interviews.

According to the allegations received, Resident #1 (R1) was informed by facility staff that they were no longer permitted to use their motorized wheelchair. It was alleged that R1 hit two staff members with their motorized wheelchair on two separate occasions and was thus prohibited from using their motorized wheelchair.
[CONTINUED ON LIC9099-C]
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Hannah Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2026
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 3
Control Number 56-AS-20251202132657
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: 01/14/2026
NARRATIVE
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Interviews with staff, residents, and outside sources revealed that staff verbally informed R1 that they were no longer permitted to use their motorized wheelchair. Review of R1’s medical assessment dated July 10, 2025, revealed that R1 had a motor impairment/paralysis. Review of R1’s needs and service plan dated July 14, 2025, revealed that R1 required standby assistance with mobility and needed an electric wheelchair / motorized cart. Review of R1’s admissions agreement revealed that there is not a motorized scooter/wheelchair policy nor addendum in the agreement. Interviews with staff corroborated that the facility does not currently have a written motorized scooter/wheelchair policy.

The Department has investigated the above-mentioned allegation and based on interviews and records review, the preponderance of evidence exists to support the allegation that staff did not allow resident to use assistive devices. One deficiency is being cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). An exit interview was conducted with Executive Director Karen Roper, to whom a copy of this report, LIC 9099-C, LIC 9099-D, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided to.

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

DATE: 01/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 56-AS-20251202132657
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/14/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/11/2026
Section Cited
CCR
87468.2(a)(27)
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87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) ... residents... shall have all of the following personal rights: (27) To keep, have access to, and use their own personal possessions...
This requirement was not met as evidence by:
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Licensee agrees to conduct an in-house training on personal rights and submit sign-in sheet and training agenda to the Department by POC due date of 2/11/2026.
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Based on interviews and records review, the licensee did not comply with the section cited above in that Resident #1 (R1) was prohibited from using their motorized wheelchair which posed a potentional personal rights risk to one (1) out of one hundred nine (109) residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Hannah Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3