<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 335530304
Report Date: 01/07/2026
Date Signed: 01/07/2026 02:48:02 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
12/24/2025 and conducted by Evaluator Paola Guerrero
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20251224175509
FACILITY NAME:LAGOON HOME CAREFACILITY NUMBER:
335530304
ADMINISTRATOR:REDFORD, DULCEFACILITY TYPE:
740
ADDRESS:6947 LAGOON CT.TELEPHONE:
(310) 528-4033
CITY:JURUPA VALLEYSTATE: CAZIP CODE:
91752
CAPACITY:6CENSUS: 6DATE:
01/07/2026
UNANNOUNCEDTIME BEGAN:
01:03 PM
MET WITH:Marlene Ocampo- CaregiverTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not ensure resident needs were met
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Paola Guerrero arrived at the facility to deliver investigative findings. LPA met with Facility Caregiver Marlene Ocampo and explained the purpose of the visit regarding the allegations listed above.

First allegation: Staff did not ensure resident needs were met. Regarding the allegation LPA conducted interviews with Resident #2 and R#3 LPA went over the alleged allegation with the residents and both residents informed LPA that facility meets their needs daily and have no concerns regarding their needs or care. Furthermore, R#2 and R#3 informed LPA that facility staff is very friendly and take good care of all residents. LPA conducted an interview with Staff #1 and S#2 LPA went over the alleged allegation with S#1 and S#2 and both S#1 and S#2 denied the allegation and informed LPA that R#1 needs were met daily. In addition, Staff #1 and S#1 denied witnessing staff not meeting the needs of the residents. LPA conducted an over the phone interview with R#1 Responsible Party/Power of Attorney LPA went over the alleged allegation with R#1 POA LPA was informed by R#1 POA that the allegations and concerns are not against the facility but rather against the hospital where R#1 was receiving care prior to being admitted to the facility. LPA conducted a walkthrough of the facility and observed facility to be clean, in good repair, and operating in safe conditions for residents in care. LPA observed enough food supply to be stored to meet the needs of residents in care. Based on corroborating evidence the department has determined that the above allegations are Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.
An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Administrator
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
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)
Page: 1 of 2
Control Number 56-AS-20251224175509
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: LAGOON HOME CARE
FACILITY NUMBER: 335530304
VISIT DATE: 01/07/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
 LPA conducted an over the phone interview with R#1 Responsible Party/Power of Attorney LPA went over the alleged allegation with R#1 POA LPA was informed by R#1 POA that the allegations and concerns are not against the facility but rather against the hospital where R#1 was receiving care prior to being admitted to the facility. LPA conducted a walkthrough of the facility and observed facility to be clean, in good repair, and operating in safe conditions for residents in care. LPA observed enough food supply to be stored to meet the needs of residents in care. Based on corroborating evidence the department has determined that the above allegations are Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Caregiver Marlene Ocampo.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
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)
Page: 2 of 2