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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 360911233
Report Date: 02/27/2026
Date Signed: 02/27/2026 12:34:03 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
02/01/2026 and conducted by Evaluator Renese Howell-Small
COMPLAINT CONTROL NUMBER: 56-AS-20260201232542
FACILITY NAME:LA POSADA IIFACILITY NUMBER:
360911233
ADMINISTRATOR:HERNANDEZ, ORFA RUTHFACILITY TYPE:
740
ADDRESS:3875 NORTH BELLE STREETTELEPHONE:
(909) 881-1344
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY:11CENSUS: 7DATE:
02/27/2026
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Administrator, Ruth ChirnovskyTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Staff did not prevent a resident from wandering from the facility
INVESTIGATION FINDINGS:
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On 02/27/2026 Licensing Program Analyst (LPA) Renese Howell-Small conducted an unannounced visit to the facility to deliver findings for the above allegation. LPA discussed the purpose of the visit Licensee/ Administrator, Ruth Chinovsky. .

The allegation that staff did not prevent a resident from wandering from the facility:
LPA interviewed staff and reviewed records. LPA reviewed R1's physician report which stated that Resident 1 (R1) has dementia. Interviews with staff revealed that the repair person left the front gate open and R1 left the facility. The facility submitted an incident report to the Department regarding Resident 1 (R1). Based upon interview and record review, this allegation is SUBSTANTIATED.

SUBSTANTIATED is defined as the complaint allegation(s) is valid and a violation has occurred based on the preponderance of available evidence. A deficiency will be cited.

An exit interview was conducted where this report LIC9099, LIC9099D and Appeal Rights were discussed, and a copies were provided to Licensee/Administrator, Ruth Chinovsky.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026
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-20260201232542
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: LA POSADA II
FACILITY NUMBER: 360911233
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/27/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/28/2026
Section Cited
CCR
87463(c)
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87463(c)Reappraisals (C) Behavioral expression... that may result in harm to self or others, such as unsafe wandering, elopement, hallucinations, lacking in hazard awareness, or lacking in impulse control. This requirement was not met as evidenced by:
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Licensee/Administrator will conduct a training on Dementia and put other procedures in place to ensure that residents can wander safely and submit proof to LPA by Plan of Correction due date (POC).
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Based on interview and record review, the licensee did not comply in the section cited above by not ensuring that Resident 1 (R1) did not leave the facility unassisted, which posed an immediate health and safety risk to 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: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026
LIC9099 (FAS) - (06/04)
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