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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361881078
Report Date: 01/15/2026
Date Signed: 01/30/2026 11:26:27 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/12/2026 and conducted by Evaluator Javier Prieto
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20260112104828
FACILITY NAME:SUMMER DREAMS ASSISTED LIVING, LLCFACILITY NUMBER:
361881078
ADMINISTRATOR:DELFIN, RANIERFACILITY TYPE:
740
ADDRESS:7425 HELLMAN AVETELEPHONE:
(909) 919-9246
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91730
CAPACITY:6CENSUS: 4DATE:
01/15/2026
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Rainier Delfin, AdministratorTIME COMPLETED:
03:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not reorder resident's medication resulting in missed medications
Due to staff neglect, resident sustained pressure injuries
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Javier Prieto arrived to the facilty to conduct a complaint investigation regarding the above allegations. LPA Prieto met with Administrator Delfin and explained the elements of the complaint.

Allegation #1 - LPA interview Administrator Delfin (S1) reveals that the staff is not responsible for ordering medications for resident #1 (R1) in care. Interview with R1's responsible party (W1) revealed that W1 is responsible for ordering medications. R1 was not available for interview at time of complaint visit. .

Allegation #2 - Medical records reveal the R1 does not require wound care or care from staff to prevent wound or pressure injuries.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
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-20260112104828
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME: SUMMER DREAMS ASSISTED LIVING, LLC
FACILITY NUMBER: 361881078
VISIT DATE: 01/15/2026
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
Based on the information obtained there is not enough evidence that staff did not reorder resident's medication resulting in missed medications and due to staff neglect, resident sustained pressure injuries . Therefore, the allegations are deemed UNSUBSTANTIATED at this time. This report was signed LPA Prieto and Administration Delfin and copy was left with the facility.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2