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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361881048
Report Date: 12/16/2025
Date Signed: 12/16/2025 02:24:09 PM

Substantiated


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
08/15/2024 and conducted by Evaluator Paola Guerrero
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240815093125
FACILITY NAME:AQUA RIDGE OF MONTCLAIRFACILITY NUMBER:
361881048
ADMINISTRATOR:MONIQUE DEL JUNCOFACILITY TYPE:
740
ADDRESS:9631 MONTE VISTA AVETELEPHONE:
(909) 483-2782
CITY:MONTCLAIRSTATE: CAZIP CODE:
91763
CAPACITY:150CENSUS: 77DATE:
12/16/2025
UNANNOUNCEDTIME BEGAN:
09:38 AM
MET WITH:Jonnathan RiosTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not provide adequate care and supervision to the residents.
Staff do not keep the facility free from bugs.
Staff do not properly maintain the facility.
Staff are not properly trained.
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 Resident Services Director Jonnathan Rios and explained the purpose of the visit regarding the allegations listed above.

First allegation: Staff do not provide adequate care and supervision to the residents. Regarding the allegation stated above LPA conducted a walkthrough of the facility memory care unit (MC), LPA inspected 13 out of 15 rooms during the inspection LPA observed a mattress to be soiled with feces along with urine. LPA conducted an interview with S#1 regarding the condition of resident’s mattress. S#1 informed LPA that R#1 still utilizes the mattress under its condition. In addition, S#1 informed LPA that family provides the mattress and family is aware of the condition of the mattress. LPA conducted a record review of R#1 physician’s report during record review LPA discovered based on Resident #1 Physical Health Status that R#1 does not have a bowel or bladder impairment. LPA observed physician report to be current.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
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 6
Control Number 56-AS-20240815093125
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: AQUA RIDGE OF MONTCLAIR
FACILITY NUMBER: 361881048
VISIT DATE: 12/16/2025
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
Second allegation: Staff do not keep the facility free from bugs. Regarding the allegation stated above, LPA conducted a walkthrough of the facility memory care unit (MC), LPA inspected 13 out of 15 rooms during the inspection LPA inspected Room #1 during the inspection LPA observed an insect that appeared to be a cockroach walking on Resident #2-bedroom floor. In addition, during the inspection LPA asked S#1 if facility provides pest control services S#1 informed LPA that facility provides treatment however, S#1 could not provide the days. LPA was informed by S#2 that facility utilizes pest control services to treat bugs/and insects.

Third allegation: Staff do not properly maintain the facility. LPA conducted a walkthrough of the facility memory care unit (MC), during the inspection LPA detected a strong foul odor of urine inside memory care area. LPA brought foul odor to Staff #1 attention and S#1 informed LPA that the urine smell comes from the carpet as the carpet can get soiled. Staff #1 informed LPA that the facility shampoos the carpet, however, S#1 could not provide LPA with the times and days that the carpet gets cleaned.

Fourth allegation: Staff are not properly trained. Regarding the allegation stated above, during the course of LPA’s inspection, interviews, record review, and observation, LPA has determined that facility staff is not properly reporting or addressing resident[s] change of condition. During interviews conducted with staff regarding the hazardous condition LPA discovered R#1 mattress to be in LPA was informed that Resident #1 exhibits behaviors that present R#1 to have bowel or bladder impairment however, based on R#1 physicians report it indicates that R#1 does not have bowel or bladder impairment. In addition, LPA did not find any documents that indicate or specify that R#1 may have a bowel/bladder impairment, or any behaviors concerning R#1 toileting needs.Based on the evidence gathered during the investigation, the above allegations are Substantiated. A finding that the complaint is Substantiated means that the findings are valid because the preponderance of the evidence standard has been met. Title 22 regulations Personal Rights of Residents in All Facilities (a) (2) & (3), 87303 Maintenance and Operation (a)(1) from division 6, chapter, article 6, is, being cited on the attached LIC 9099 D.


An exit interview was conducted where this report, appeal rights, and LIC9099-D was discussed, and a copy of the report was provided to Facility Resident Services Director Jonnathan Rios at the conclusion of the visit.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 56-AS-20240815093125
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: AQUA RIDGE OF MONTCLAIR
FACILITY NUMBER: 361881048
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/16/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/27/2025
Section Cited
HSC
87468.1(a)(2)
1
2
3
4
5
6
7
87468.1 Personal Rights of Residents in All Facilities...(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:...(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
The Licensee has agreed to provide training on regulation "Personal Rights of Residents in All Facilities" for all care staff and will provide signed copy by all staff to LPA by POC date 12/27/2025. Licensee will also provide LPA with an update concerning the mattress replacement for R#1.
8
9
10
11
12
13
14
Based on observation and interviews the licensee did accord R#1 with comfortable accommodations and furnishings, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.
8
9
10
11
12
13
14
Type B
12/27/2025
Section Cited
HSC
87468.1(3)
1
2
3
4
5
6
7
87468.1 Personal Rights of Residents in All Facilities...(3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination.
1
2
3
4
5
6
7
The Licensee has agreed to provide training in the regulation listed above concerning facilities to be free of insects and rodents. Licensee will also provide updated invoices for all rooms being serviced by pest control to LPA by POC date 12/27/2025.
8
9
10
11
12
13
14
Based on observation the licensee did not comply with personal rights regulation which LPA found insect (cockroach) in Room#1 in R#2 room floor, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.
8
9
10
11
12
13
14
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: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 56-AS-20240815093125
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: AQUA RIDGE OF MONTCLAIR
FACILITY NUMBER: 361881048
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/16/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/17/2025
Section Cited
CCR
87303(a)(1)
1
2
3
4
5
6
7
87303 Maintenance and Operation...(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors...(1) Floor surfaces in bath, laundry and kitchen areas shall be maintained in a clean, sanitary, and odorless condition.

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
The Licensee has agreed to provide training on regulation “Maintenance and Operation" to all care staff and will provide a signed copy by all staff to LPA by POC date 12/27/2025. License will also ensure that Memory Care Unit is maintained clean, sanitary, and odorless condition.
8
9
10
11
12
13
14
Based on observation and interviews the licensee did comply with Maintenance and Operation regulation, by maintaining facility clean, sanitary, and odorless condition. which poses an immediate Health, Safety, or Personal Rights risk to persons in care.
8
9
10
11
12
13
14
Type B
12/27/2025
Section Cited
CCR
87411(a)
1
2
3
4
5
6
7
Personnel Requirements - General
(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required in Section 87608, Postural Supports. Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment and grounds.

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
The Licensee has agreed to provide training on regulation " Personnel Requirements - General" to all care staff and ensure that care staff reports and updates all residents’ change of conditions. Licensee will provide a signed copy by all staff to LPA by POC date 12/27/2025.
8
9
10
11
12
13
14
Based on observation and interviews the licensee did comply with Personnel Requirements regulation, by ensuring staff to be competent to provide the services necessary to meet resident needs, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.
8
9
10
11
12
13
14
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: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 6
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
08/15/2024 and conducted by Evaluator Paola Guerrero
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240815093125

FACILITY NAME:AQUA RIDGE OF MONTCLAIRFACILITY NUMBER:
361881048
ADMINISTRATOR:MONIQUE DEL JUNCOFACILITY TYPE:
740
ADDRESS:9631 MONTE VISTA AVETELEPHONE:
(909) 483-2782
CITY:MONTCLAIRSTATE: CAZIP CODE:
91763
CAPACITY:150CENSUS: 77DATE:
12/16/2025
UNANNOUNCEDTIME BEGAN:
09:38 AM
MET WITH: Jonnathan RiosTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff allow the residents to be soaking wet
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 Resident Services Director Jonnathan Rios and explained the purpose of the visit regarding the allegations listed above.

First allegation: Staff allow the residents to be soaking wet. Regarding the allegation stated above, LPA conducted a walkthrough on the Facility Memory Care Unit during the walkthrough LPA observed 18 residents to be sitting in the family room/living room area and observed all 18 residents to be clean, and in good hygiene care. LPA conducted an interview with S#1 who informed LPA that all residents toileting is completed every two hours or as needed. LPA was also informed by staff that laundry services are done frequently LPA collected laundry schedule as well as residents shower schedule. During the review or resident’s shower schedule LPA observed residents to receive shower twice-three times a day.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 56-AS-20240815093125
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: AQUA RIDGE OF MONTCLAIR
FACILITY NUMBER: 361881048
VISIT DATE: 12/16/2025
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
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 at the end of the visit.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 6