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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336426747
Report Date: 11/26/2025
Date Signed: 11/26/2025 11:46:27 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE 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
09/17/2025 and conducted by Evaluator Abdoulaye Zerbo
COMPLAINT CONTROL NUMBER: 18-AS-20250917141511
FACILITY NAME:ANGELIC HANDS ASSISTED LIVINGFACILITY NUMBER:
336426747
ADMINISTRATOR:LUNA, SYNTHIA MARIEFACILITY TYPE:
740
ADDRESS:82397 STRADIVARI ROADTELEPHONE:
(760) 342-0248
CITY:INDIOSTATE: CAZIP CODE:
92203
CAPACITY:6CENSUS: 4DATE:
11/26/2025
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Tina SmithTIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
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8
9
Licensee failed to issue refund.
Licensee signed resident up for hospice without consent from responsible party.
Facility staff failed give resident their belongings after being discharged.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted a subsequent complaint visit to deliver final findings for the above allegations. During today’s visit, LPA met with Tina Smith and explained the reason for the visit. Licensee Synthia Luna was contacted via telephone.
It was alleged that Licensee failed to issue refund. Concerns were raised that after resident 1 (R1) left the facility, the facility staff refused to issue a refund. LPA interviewed the licensee and the information obtained revealed R1 was admitted under the Assisted Living Waiver (ALW) program. A $500 pre-admission fee was collected when moving in. according to licensee and records review, the $500 was meant to cover the Administrator’s time to complete the necessary documentation (Assessment, contact physician).

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Abdoulaye Zerbo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2025
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 18-AS-20250917141511
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: ANGELIC HANDS ASSISTED LIVING
FACILITY NUMBER: 336426747
VISIT DATE: 11/26/2025
NARRATIVE
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The Licensee further stated that the facility held the resident’s bed for approximately two months following his departure, more than what is required in accordance with program guidelines.
It was alleged that Licensee signed resident up for hospice without consent from responsible party (RP). Concerned were raised that the RP was contacted by a hospice representative requested medical records to determine eligibility for hospice. LPA conducted interview with licensee and the information obtained revealed that no hospice agencies were contacted for R1. There is no documentation or evidence indicating that hospice services were initiated or that medications were administered without proper authorization.
It was alleged facility staff failed to give resident their belongings after being discharged. They alleged that the facility retained the resident’s personal belongings, including a quilt, medications, clothing, slippers, a painting, and food. The Licensee confirmed that the belongings remain at the facility and have not been discarded or withheld. The Licensee stated that multiple attempts were made by the Ombudsman to contact the RP to arrange for pickup of the items, but no response was received. The facility has maintained possession of the items in a secure location and has expressed willingness to return them at any time.

Based on observations, interviews, and records review, the allegations listed above are unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

An exit interview was conducted, this report was reviewed via telephone with Licensee Synthia Luna and a copy was provided to Caregiver Tina Smith.

SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Abdoulaye Zerbo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2