361800198-2-27-2026-56-AS-EMAN-DSAUKC-20260318153854

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361800198
Report Date: 02/27/2026
Date Signed: 02/27/2026 11:46:02 AM

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
02/25/2026 and conducted by Evaluator Paola Guerrero

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20260225120958

FACILITY NAME:	MGB CARMEL MANOR		FACILITY NUMBER:	361800198
ADMINISTRATOR:	BERNAL, GLENN		FACILITY TYPE:	740
ADDRESS:	457 WEST 13TH STREET		TELEPHONE:	(909) 982-4786
CITY:	UPLAND	STATE: CA	ZIP CODE:	91786
CAPACITY:	6	CENSUS: 6	DATE:	02/27/2026
		UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Glenn Bernal		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff did not prevent a resident from hitting another resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Paola Guerrero arrived at the facility to deliver investigative findings. LPA met with Facility Administrator Glenn Bernal and explained the purpose of the visit regarding the allegation stated above.

First allegation: Staff did not prevent a resident from hitting another resident. Regarding the allegation, LPA conducted an interview with Staff #1 and Staff #2 LPA went over the alleged allegation with Staff #1 and Staff #2, LPA was informed by S#1 and S#2, that early in the morning (3:00am), staff heard a loud shout that came across the hallway, S#2 informed LPA that S#2 observed R#1 in the wall way across from the bathroom holding their left side of their head. Staff #2 informed that R#1 indicated that Resident #2 had hit Resident #1 with their cane. LPA conducted an interview with Resident #2 LPA went over the alleged allegation with Resident #2 pertaining to Resident #2 hitting Resident #1. Resident #2 informed LPA that resident had woken up to use the bathroom, and while attempting to utilize the bathroom Resident #2 informed LPA that Resident #1 grabbed Resident #2 by the arm.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
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-20260225120958

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: MGB CARMEL MANOR	FACILITY NUMBER: 361800198
	VISIT DATE: 02/27/2026

NARRATIVE

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Resident #2 further explained to LPA about being legally blind and when Resident #1 grabbed Resident #2 by the arm it startled the resident and that is why resident reacted by hitting Resident #1. Resident #2 informed LPA that it wasn’t an intentional act to hit Resident #1 but a reaction of fear of not knowing who grabbed resident by the arm. Staff #1 and Staff #2 informed LPA that staff immediately assessed Resident #1 and indicated that no manor injuries to Resident #1 were reported. 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 Glenn Bernal.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
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

LIC9099 (FAS) - (06/04)

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